CAJ | 학술논문

目的：探讨脑干脑炎的临床及影像学特点,以减少临床误诊误治。方法回顾性分析15例脑干脑炎的临床资料。结果本组4例存在前驱感染病史,临床常见症状为头晕、步态不稳,相对特异症状为呃逆及延髓性麻痹；病灶以侵犯脑桥、延髓为主；脑脊液检查缺乏典型表现,压力轻度升高2例,3例可见蛋白-细胞分离现象。结合患者临床表现、发病特点及相关医技检查结果诊断为脑干脑炎。1例自行痊愈,余给予糖皮质激素和(或)免疫球蛋和(或)抗病毒治疗,13例明显好转,1例复发。结论脑干脑炎病因尚不明确,诊断需结合临床表现、发病特点及相关医技检查结果综合分析,动态头颅MRI检查可帮助诊断；本病予糖皮质激素、丙种球蛋白及抗病毒药物治疗有效,大多预后良好。
목적：탐토뇌간뇌염적림상급영상학특점,이감소림상오진오치。방법회고성분석15례뇌간뇌염적림상자료。결과본조4례존재전구감염병사,림상상견증상위두훈、보태불은,상대특이증상위애역급연수성마비；병조이침범뇌교、연수위주；뇌척액검사결핍전형표현,압력경도승고2례,3례가견단백-세포분리현상。결합환자림상표현、발병특점급상관의기검사결과진단위뇌간뇌염。1례자행전유,여급여당피질격소화(혹)면역구단화(혹)항병독치료,13례명현호전,1례복발。결론뇌간뇌염병인상불명학,진단수결합림상표현、발병특점급상관의기검사결과종합분석,동태두로MRI검사가방조진단；본병여당피질격소、병충구단백급항병독약물치료유효,대다예후량호。
Objective To investigate the clinical and neuroimaging features of brainstem encephalitis to avoid the misdiagnosis and mistreatment. Methods Retrospective analysis of the clinical data of 15 cases with brain stem encephalitis was conducted. Results Precursor infection history was reported in 4 cases;mainly in young adults;dizziness and unstable walking instability were common clinical symptoms and bulbar paralysis and hiccup were the relatively specific symptoms. Pons and medulla were the primary lesions. Typical feature was rarely found in cerebrospinal fluid examination, and protein-cell separation phenomenon was found in 3 cases; self-healing occurred in 1 case, the others were given glucocorticoid and ( or) immune globulin and ( or) antiviral therapy. 13 cases turned for the better significantly, and recurrence was reported in 1 case. Conclusion The etiology of brain stem encephalitis is unclear. Diagnosis of brain stem encephalitis should be based on the comprehensive analysis of clinical manifestations, clinical features and auxiliary examination results. Dynamic brain MRI examination is helpful to the diagnosis. The disease responds well to glucocorticoids, gamma globulin and antiviral drugs with favorable prognosis.