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目的 总结海洛因海绵状白质脑病 (HSLE)的临床、影像和病理特征。方法 2 8例患者的临床、CT和MRI分析 ,2例脑部解剖和 8例脑活检和电镜观察。结果 HSLE的临床、影像和病理特点 :(1)有烫吸海洛因病史 ;(2 ) 2 8例患者都有戒毒史 ,17例在戒毒过程中发病 ,8例戒毒后 1～ 2个月发病 ,2例在戒毒后 4个月发病 ,1例吸入大量海洛因后发病 ,戒毒后症状加重 ;(3)多数患者急性起病 ,多以小脑受损为首发症状 ;(4)锥体束受损常见 ,感觉正常 ;(5 )脑脊液正常 ;(6 )头部CT和MRI示大脑、小脑白质广泛对称性受累 ;(7)主要病理改变为脑白质海绵状空泡变性。结论 中国大陆首次发现HSLE。有海洛因烫吸史者出现小脑症状时 ,要考虑到HSLE。主要病理改变为脑白质海绵状空泡变
Objective To summarize the clinical, imaging and pathological features of heroin spongiform encephalopathy (HSLE). Methods 28 cases of patients with clinical, CT and MRI analysis, 2 cases of brain anatomy and 8 cases of brain biopsy and electron microscopy. Results The clinical, imaging and pathological features of HSLE were as follows: (1) there was a history of heroin abuse; (2) 28 patients had history of drug addiction treatment, 17 patients developed detoxification process and 8 patients developed disease 1 to 2 months after detoxification, 2 cases in 4 months after detoxification onset, a case of large amount of heroin inhalation, the symptoms aggravated; (3) most patients with acute onset, mostly cerebellar damage as the first symptom; (4) pyramidal tract damage common , Normal; (5) cerebrospinal fluid normal; (6) CT and MRI of the head showed extensive symmetry of the cerebellum and cerebellar white matter involvement; (7) The main pathological changes were degeneration of white matter spongy vacuoles. Conclusion The first discovery of HSLE in mainland China. There are history of heroin abuse when there cerebellar symptoms, to take into account the HSLE. The main pathological changes of white matter sponge-like vacuoles