Abstract:
A 65-year-old woman presented with slowly progressive aphasia with gait disturbance associated with parkinsonism. She experienced a fall that resulted in a brain trauma. Brain imaging revealed a small amount of subarachnoid hemorrhage (SAH) with intraventricular bleeding. Despite conservative therapy, gait disturbance and hyporesponsiveness gradually deteriorated following that brain trauma. One month later, she was transferred to our hospital, and magnetic resonance imaging revealed prominent communicating hydrocephalus. A ventriculoperitoneal shunt and brain biopsy were performed. Neurosurgical intervention did not improve the patient\'s neurological condition. Clinical-pathological analysis confirmed the diagnosis of corticobasal degeneration (CBD) as an underlying disease relating to parkinsonism and aphasia. In patients with parkinsonism with high risks of falling, attention should be paid to neurological deterioration due to traumatic SAH-related hydrocephalus. Particularly, in patients with aphasia such as in those with CBD, delayed detection of posttraumatic complications might cause poor responsiveness to surgical intervention.
摘要:
一名65岁女性出现缓慢进行性失语症,步态障碍与帕金森病相关。她经历了一次摔倒,导致了脑部创伤。脑成像显示少量蛛网膜下腔出血(SAH)伴脑室内出血。尽管保守治疗,步态障碍和低反应性在脑外伤后逐渐恶化。一个月后,她被转到我们医院,磁共振成像显示明显的交通性脑积水。进行了脑室-腹腔分流术和脑活检。神经外科干预并没有改善患者的神经系统状况。临床病理分析证实了皮质基底变性(CBD)的诊断为与帕金森病和失语症有关的潜在疾病。对于跌倒风险高的帕金森病患者,应注意外伤性SAH相关脑积水引起的神经功能恶化。特别是,在失语症患者中,例如CBD患者,创伤后并发症的延迟检测可能导致对手术干预的反应性较差.