3 0 0 0 OA MRI拡散強調画像にて脳梁膨大部に可逆性高信号域を認めた成人3症例の検証
- 著者
- 鈴木 重將 内山 剛 明神 寛暢 渡邊 一樹 山本 大介 佐藤 慶史郎 大橋 寿彦
- 出版者
- 一般社団法人 日本神経救急学会
- 雑誌
- Journal of Japan Society of Neurological Emergencies & Critical Care (ISSN:24330485)
- 巻号頁・発行日
- vol.30, no.2, pp.62-66, 2018-06-01 (Released:2018-11-15)
- 参考文献数
- 8
Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is diagnosed using imaging and is characterized by a favorable prognosis, which often improves without treatment. Here, we report three adult patients with MERS who were treated with a different course each; all of them required immunotherapy to some extent. The first case was a 67-year-old male who experienced gastrointestinal symptoms for 3 months prior to hospitalization. The second was a 38-year-old male who experienced a headache and fever, followed by urinary retention. The third was a 36-year-old male who experienced a fever and headache, followed by dysuria, impaired orientation, and upper limb tremor; he was transported to our hospital on the same day. All patients had lesions in the splenium of the corpus callosum. While two patients responded well to steroid pulse therapy, one demonstrated poor response and required immunoadsorption therapy. While some patients with adult-onset MERS require aggressive immunotherapy, this condition covers a broader range of diseases in adults with varying premonitory and clinical symptoms. Although pediatric MERS is often accompanied with a benign condition, this is not always the case for adults. Thus, considering immunotheraphy may be essential.
3 0 0 0 OA MRSA除菌のためのカテキン吸入療法の検討
- 著者
- 鈴木 万幾子 内山 剛 高橋 均 伊藤 充子 清水 貴子 小林 寛 大橋 寿彦
- 出版者
- 日本神経学会
- 雑誌
- 臨床神経学 (ISSN:0009918X)
- 巻号頁・発行日
- vol.49, no.9, pp.586-589, 2009 (Released:2009-11-13)
- 参考文献数
- 7
- 被引用文献数
- 3 1
症例は57歳男性.全般性痙攣で発症し,左前頭葉に病変をみとめ,脳生検では反応性astrocyteの増生と血管周囲性のT細胞優位のリンパ球浸潤がめだった.病変は自然消退し,18カ月後に左小脳脚の病変を再発したが,ふたたび自然消退した.初発から2年後に脳梁に再発し,当初は多発性硬化症をうたがったが,ぶどう膜炎を合併,ステロイド抵抗性であり,再生検でびまん性大細胞型B細胞性リンパ腫と診断した.自然軽快する症候性病変をくりかえした中枢神経系悪性リンパ腫の1例について,2回の脳生検病理と臨床経過を報告した.