Occurrence of Subtle Scoliosis in Accordance with Development of Ipsilateral Cerebellar Diaschisis on Brain SPECT in a Patient with Head Injury

頭部外傷患者脊椎側彎併發腦造影呈現同側小腦失聯現象

張幸初(Shin-Tsu Chang) ； 樊裕明(Yu-Ming Fan)

《核子醫學雜誌》 18卷3期 (2005/09) Pp. 173-179

https://doi.org/10.6332/ANMS.1803.007

摘要

一位23歲，二十個月前曾有頭部外傷的男性患者因自覺身高變矮而前來就診，脊椎側彎系列(scoliosis series)X光檢查發現胸－腰椎輕度向左側彎四度(Cobb's method測量），核醫腦單光子射出電腦斷層造影呈現左側小腦放射活性訊號減弱，是為同側小腦失聯絡現象(ICD)。此現象在以往的文獻中並未被提及，且由於出現脊椎側彎而致身高變化的時間點與ICD發生的時間吻合，故推測此兩者具有很強的關聯性。

關鍵字

頭部外傷 ； 脊椎側彎 ； 腦單光子斷層造影 ； 小腦失聯絡

並列摘要

A 23-year-old male patient with a head injury 20 months ago visited our OPD on account of shortening height from 167 cm to 165 cm within a 2-month period. Scoliosis series of the whole spine X-rays revealed a slight convex in the left side with a 4-degree curve of scoliosis measured by the Cobb's method. Brain SPECT with (superscript 99m)Tc-HMPAO images showed a reduction of perfusion to the left cerebellar hemisphere, e.g. ipsilateral cerebellar diaschisis (ICD), because the left cerebral cortex had severely wronged including the left frontal, temporal and parietal-occipital regions. We speculated that the occurrence of scoliosis together with impaired cerebellar perfusion following head injury might be associated with damage to the efferent fibers from the cerebellum and the ICD observed in the chronic stage of brain damage probably was caused by a late involvement of the cortico-ponto-cerebellar tract at the level of the frontal cortex.

並列關鍵字

head injury ； scoliosis ； brain SPECT ； ipsilateral cerebellar diaschisis