伴皮质及脑膜强化的低渗性脑病二例

摘要

Objective To report case history and the clinical features in two cases of hyponatremic encephalopathy accompany with meningeal and cortical enhancement ; and to discuss possible pathogenesis and differential diagnosis.Methods The case history, clinical manifestations , laboratory examinations, differential diagnosis and treatment Effectiveness was analyzed retrospectively .The possible pathogenesis was discussed.Results The onset symptom of the two cases were change of content of consciousness , then followed with convulsion and coma.Cerebrospinal fluid analysis were normal.On brain magnetic resonance imaging, meningeal and cortical enhancement exists in both of the two cases .The symptoms were improved in one case after treated with glucocorticoids.Conclusion Hyponatremic encephalopathy should be evaluated in a patient with onset of abnormal conscious content followed with convulsion and coma , and having meningeal and cortical enhancement on magnetic resonance imaging.Promptly diagnosis and early treatment could improve the prognosis of some patients.%目的：探讨伴皮质及脑膜强化低渗性脑病的病史、临床特征、病理机制、鉴别诊断和临床意义。方法分析2例伴皮质及脑膜强化的低渗性脑病患者的病史、临床表现、实验室资料、鉴别诊断和疗效。结果2例患者均存在诱发低钠血症的病史，以意识内容改变起病，随后抽搐、昏迷。实验室检查均无明显异常。头颅磁共振均存在皮质及相邻脑膜强化。激素治疗后，1例患者症状明显改善。结论临床以意识改变起病，随后抽搐、意识水平改变，影像学出现皮质及脑膜强化的患者，应排除低渗性脑病。