Abstract：
To describe the radiological features of patients with headache as a presenting symptom of neurosarcoidosis.
Neurologic complications occur in approximately 5%-10% of patients with sarcoidosis, and approximately 50% of these patients have neurologic deficits at the time sarcoidosis is first diagnosed. A wide spectrum of central and peripheral nervous system clinical manifestations may be observed, including cranial nerve palsies, sensory and/or motor deficits, and headache. Magnetic resonance imaging (MRI) results in patients with neurosarcoidosis may include abnormal contrast enhancement, structural masses, and demyelinating lesions.
This single-center retrospective cohort study assessed patients who were diagnosed with neurosarcoidosis in an urban tertiary care center between 1995 and 2016. We included patients who had MRI results at the time of diagnosis. Patients were divided into two groups based on the presence or absence of headache as a presenting symptom. The MRI result of meningeal contrast enhancement was reviewed.
Of the 110 patients analyzed, 30 (27.3%) had an initial presenting symptom of headache while 80 (72.7%) did not. Patients with headache had a higher proportion of meningeal contrast enhancement on MRI (66.7% [20/30] vs. 25.0% [20/80]; p < 0.001) and leptomeningeal involvement (53.3% [16/30] vs. 7.5% [6/80], p < 0.001) compared to patients with no headache. However, those with headache had a lower proportion of spinal cord localization (13.8% [4/29] vs. 34.2% [26/76], p = 0.038) and intraparenchymal central nervous system involvement (16.7% [5/30] vs. 51.3% [41/80], p = 0.001) compared to patients with no headache.
Patients with neurosarcoidosis who presented with headache as an initial symptom had a higher proportion of meningeal contrast enhancement seen by MRI than patients who presented with other neurological symptoms. This suggests a clinico-radiologic link between headache and meningeal disruption in patients with neurosarcoidosis.
Neurologic complications occur in approximately 5%-10% of patients with sarcoidosis, and approximately 50% of these patients have neurologic deficits at the time sarcoidosis is first diagnosed. A wide spectrum of central and peripheral nervous system clinical manifestations may be observed, including cranial nerve palsies, sensory and/or motor deficits, and headache. Magnetic resonance imaging (MRI) results in patients with neurosarcoidosis may include abnormal contrast enhancement, structural masses, and demyelinating lesions.
This single-center retrospective cohort study assessed patients who were diagnosed with neurosarcoidosis in an urban tertiary care center between 1995 and 2016. We included patients who had MRI results at the time of diagnosis. Patients were divided into two groups based on the presence or absence of headache as a presenting symptom. The MRI result of meningeal contrast enhancement was reviewed.
Of the 110 patients analyzed, 30 (27.3%) had an initial presenting symptom of headache while 80 (72.7%) did not. Patients with headache had a higher proportion of meningeal contrast enhancement on MRI (66.7% [20/30] vs. 25.0% [20/80]; p < 0.001) and leptomeningeal involvement (53.3% [16/30] vs. 7.5% [6/80], p < 0.001) compared to patients with no headache. However, those with headache had a lower proportion of spinal cord localization (13.8% [4/29] vs. 34.2% [26/76], p = 0.038) and intraparenchymal central nervous system involvement (16.7% [5/30] vs. 51.3% [41/80], p = 0.001) compared to patients with no headache.
Patients with neurosarcoidosis who presented with headache as an initial symptom had a higher proportion of meningeal contrast enhancement seen by MRI than patients who presented with other neurological symptoms. This suggests a clinico-radiologic link between headache and meningeal disruption in patients with neurosarcoidosis.
摘要：
目的：描述作为神经结节病表现症状的头痛患者的放射学特征。
背景：大约5％-10％的结节病患者发生神经系统并发症，在首次诊断结节病时，这些患者中约有50％存在神经系统缺陷。可以观察到广泛的中枢和周围神经系统临床表现，包括颅神经麻痹,感觉和/或运动缺陷，和头痛。神经结节病患者的磁共振成像（MRI）结果可能包括异常的对比增强，结构质量,和脱髓鞘病变。
方法：这项单中心回顾性队列研究评估了1995年至2016年在城市三级护理中心诊断为神经结节病的患者。我们纳入了在诊断时具有MRI结果的患者。根据是否存在头痛作为表现症状，将患者分为两组。对脑膜增强的MRI结果进行了回顾。
结果：在分析的110例患者中，30（27.3%）有头痛的初始症状，而80（72.7%）没有。头痛患者在MRI上的脑膜对比增强比例较高（66.7％[20/30]与25.0%[20/80]；p<0.001）和软脑膜受累（53.3%[16/30]vs.7.5%[6/80]，p<0.001）与没有头痛的患者相比。然而,头痛患者的脊髓定位比例较低(13.8%[4/29]vs.34.2%[26/76]，p=0.038）和脑实质中枢神经系统受累（16.7%[5/30]vs.51.3%[41/80]，p=0.001）与没有头痛的患者相比。
结论：以头痛为首发症状的神经结节病患者的MRI表现出的脑膜对比增强比例高于以其他神经系统症状的患者。这表明神经结节病患者头痛和脑膜破裂之间存在临床放射学联系。
背景：大约5％-10％的结节病患者发生神经系统并发症，在首次诊断结节病时，这些患者中约有50％存在神经系统缺陷。可以观察到广泛的中枢和周围神经系统临床表现，包括颅神经麻痹,感觉和/或运动缺陷，和头痛。神经结节病患者的磁共振成像（MRI）结果可能包括异常的对比增强，结构质量,和脱髓鞘病变。
方法：这项单中心回顾性队列研究评估了1995年至2016年在城市三级护理中心诊断为神经结节病的患者。我们纳入了在诊断时具有MRI结果的患者。根据是否存在头痛作为表现症状，将患者分为两组。对脑膜增强的MRI结果进行了回顾。
结果：在分析的110例患者中，30（27.3%）有头痛的初始症状，而80（72.7%）没有。头痛患者在MRI上的脑膜对比增强比例较高（66.7％[20/30]与25.0%[20/80]；p<0.001）和软脑膜受累（53.3%[16/30]vs.7.5%[6/80]，p<0.001）与没有头痛的患者相比。然而,头痛患者的脊髓定位比例较低(13.8%[4/29]vs.34.2%[26/76]，p=0.038）和脑实质中枢神经系统受累（16.7%[5/30]vs.51.3%[41/80]，p=0.001）与没有头痛的患者相比。
结论：以头痛为首发症状的神经结节病患者的MRI表现出的脑膜对比增强比例高于以其他神经系统症状的患者。这表明神经结节病患者头痛和脑膜破裂之间存在临床放射学联系。
