Posterior Reversible Encephalopathy Syndrome and Cerebral Vasculopathy Associated With Influenza A Infection: Report of a Case and Review of the Literature
Posterior Reversible Encephalopathy Syndrome and Cerebral Vasculopathy Associated With Influenza A Infection: Report of a Case and Review of the Literature
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DOI：
10.1097/rct.0b013e3181993a43
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发表时间：
2009-11-01
影响因子：
1.3
通讯作者：
Boardman, John F.
中科院分区：
文献类型：
--
作者：
Bartynski, Walter S.;Upadhyaya, Ameet R.;Boardman, John F.
背景和目的：甲型流感感染可导致脑病、脑炎或雷氏综合征，并伴随着儿童脑水肿的发展，并与成人卒中发病率的增加有关。人们对这些事件的机制知之甚少。后部可逆性脑病综合征(PRES)与感染/脓毒症相关，脑血管病变在PRES中已被证实。我们描述了一例与甲型流感相关的PRES病例。病例摘要：一名血压正常的65岁女性，在一种病毒性前驱疾病的背景下表现出神志改变和恶心，最终确诊为甲型流感。后部可逆性脑病综合征发生在入院后第二天。导管脑血管造影术发现PRES受累区域有血管病变，有局限性血管扩张和珠串出现。结论：甲型流感和PRES与脑血管病变的记录相关联，提示PRES和流感相关的脑性水肿和卒中背后有共同的全身血管机制。
Background and Purpose: Influenza A infection can precipitate encephalopathy, encephalitis, or Reye syndrome with the development of cerebral edema in children and is associated with an increased incidence of stroke in adults. The mechanism of these events is poorly understood. Posterior reversible encephalopathy syndrome (PRES) is seen in association with infection/sepsis, and cerebral vasculopathy has been demonstrated in PRIES. We describe a case of PRES that develops in association with influenza A.Summary of Case: A normotensive 65-year-old woman presented with altered mentation and nausea in the setting of a viral prodromal illness ultimately confirmed as influenza A. Posterior reversible encephalopathy syndrome developed on the second day after admission. Catheter cerebral angiogram documented vasculopathy in PRES-involved regions with areas of focal vessel dilatation and string-of-bead appearance.Conclusions: The association between influenza A and PRES with documentation of cerebral vasculopathy suggests a common systemic vascular mechanism behind PRIES and influenza-related encephalopathic edema and stroke.