MRI Findings of Central Pontine and Extrapontine Myelinolysis Related to Rapid Correction of Hyponatremia: Case Report

快速修正低血中鈉濃度導致橋腦中及橋腦外髓鞘質變性磁共振影像

林坤榮(Kun-Eng Lim) ； 葉文凌(Boon-Lian Yeh) ； 許元昱(Yuan-Yu Hsu) ； 王超然(Chan-Ran Wang) ； 徐文慶(Wen-Chin Hsu)

《中華放射線醫學雜誌》 23卷5期 (1998/10) Pp. 183-186

摘要

本文報告一例快速修正低血中鈉濃度導致橋腦中及橋腦外髓鞘質變性。病人右腳骨折，接受手術治療後發生低血中鈉濃度，在經由快速靜脈注射生理靈水後，四天內將低血中鈉濃度修正回正常數值。但四天後，病人發生吞嚥困難、語言不清、四肢無力、面無表情、坐立不安等情形。核磁共振顯示橋腦及基底核在T2比重影像中有高訊號病兆。透過支持性療法，病人症狀已完全恢復，連續的MRI結果顯示橋腦中及橋腦外的變化完全消失。

關鍵字

腦 ； 異常 ； 磁共振影像 ； 橋腦中髓鞘質變性

並列摘要

We report on a patient who developed central pontine myelinolysis and extrapontine myelinolysis after rapid correction of hyponatremia. He suffered open leg fracture, received operative room internal fixation, and followed by occurrence of hyponatremia. The hyponatremia was reestablished to normal levels by rapid infusion of normal saline solution over four days. Following this, he developed dysphagia, dysarthria, apathy, restlessness, and weakness in his limbs. An MRI showed symmetrical, hyperintense lesion in the pons and bilateral symmetric hyperintense lesions in the basal ganglia on T2-weighted images. After supportive treatment, the patient fully recovered without disability. Serial MRI showed complete resolution of the initial pontine and extrapontine changes.

並列關鍵字

Brain ； abnormality ； Magnetic resonance imaging ； Central pontine myelinolysis