Transient brain shrinkage in infantile spasms after ACTH treatment. Report of two cases.
Transient brain shrinkage in infantile spasms after ACTH treatment. Report of two cases.
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ACTH 治疗后婴儿痉挛症的短暂脑萎缩。
DOI：
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
I. Tamai
中科院分区：
文献类型：
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作者：
K. Maekawa;H. Ohta;I. Tamai
这是两个婴儿痉挛症的病例报告，表现为短暂的脑萎缩电脑断层扫描（CT）后，促肾上腺皮质激素治疗。促肾上腺皮质激素给一个8个月大的日本婴儿痉挛症女孩8周。在最后一次注射ACTH后2周进行的第一次CT显示中度脑萎缩。4个月时的第二次CT显示收缩明显减少。促肾上腺皮质激素也给了8周的14个月大的日本男孩与婴儿痉挛。第一次CT，就在ACTH治疗前，显示轻度皮质萎缩，第二次在最后一次注射ACTH后7天显示明显的脑萎缩和中度脑室扩张，第三次在2个月时，显示萎缩轻度改善。ACTH或皮质类固醇对发育中的神经系统有广泛的影响。在动物实验中，促肾上腺皮质激素或类固醇干扰年轻大鼠的大脑发育。婴儿痉挛症患儿短暂性脑萎缩的CT表现可能提示婴儿期ACTH或类固醇的强化治疗会干扰脑生长，如动物实验结果所示。
This is the report of two cases of infantile spasms, manifesting transient brain shrinkage in computerized tomography (CT) after ACTH treatment. ACTH was given for 8 weeks to a 8-months-old Japanese girl with infantile spasms. First CT performed at 2 weeks after the final ACTH injection, displayed moderate brain shrinkage. Second CT at 4 months showed marked diminution of the shrinkage. ACTH was also given for 8 weeks to a 14 months old Japanese boy with infantile spasms. First CT, just before ACTH treatment, showed mild cortical atrophy, the second at 7 days after the final ACTH injection revealed marked brain shrinkage and moderate ventricular dilatation, and the third at 2 months, disclosed mild improvement of the shrinkage. ACTH or corticoateroid has widespread effects on the developing nervous system. In animal experiments, ACTH or steroids interfere with brain growth of young rats. CT findings of transient brain shrinkage in a child with infantile spasms might suggest that intensive treatment with ACTH or steroids in infancy interferes with brain growth as seen in the results of animal experiments.