The clinical spectrum of haemorrhagic CNS inflammatory demyelinating lesions

被引:2
作者
Hardy, Todd A. [1 ,2 ]
Guo, Yong [3 ]
Flanagan, Eoin P. [3 ]
Lucchinetti, Claudia F. [3 ,4 ]
Tobin, W. Oliver [3 ]
机构
[1] Univ Sydney, Concord Repatriat Gen Hosp, Dept Neurol, Neuroimmunol Clin, Concord Rd, Concord West, NSW 2139, Australia
[2] Univ Sydney, Brain & Mind Ctr, Camperdown, NSW, Australia
[3] Mayo Clin, Dept Neurol, Rochester, MN USA
[4] Mayo Clin, Coll Med & Sci, Rochester, MN USA
关键词
Multiple sclerosis; acute disseminated encephalomyelitis; susceptibility weighted imaging; blood; haemorrhage; acute haemorrhagic leukoencephalitis; atypical demyelination; tumefactive demyelination; MULTIPLE-SCLEROSIS LESIONS; LEUKOENCEPHALITIS; REVISIONS; CRITERIA; PATIENT;
D O I
10.1177/13524585221094241
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Haemorrhagic demyelinating lesions are rare, and little is known about the demyelinating diseases with which they are associated, or how lesional haemorrhage affects treatment and outcomes. Objective: To examine the clinical characteristics and outcomes of patients with demyelinating lesions and magnetic resonance imaging (MRI) evidence of haemorrhage seen at the Mayo clinic between 1990 and 2018. Methods: The Mayo Clinic's medical-record diagnostic-linkage system was used to identify patients with CNS demyelinating disease and parenchymal haemorrhage on brain MRI cross-referenced against a database of patients with pathologically confirmed CNS demyelinating disease. The clinical characteristics, diagnosis, MRI findings, brain histopathology, and outcomes of these patients were reviewed. Results: Ten patients with haemorrhagic demyelination were identified, including three patients who underwent a brain biopsy. The main findings were that haemorrhagic demyelinating lesions most often occur in atypical forms of demyelination, especially acute haemorrhagic leukoencephalitis (AHL, or Weston-Hurst disease) and tumefactive demyelination, and rarely in multiple sclerosis. A spectrum of outcomes was observed for these patients ranging from complete remission through to high level disability. Conclusion: Lesional haemorrhage is uncommon in demyelinating disease where it is most closely associated with AHL. Bleeding within a demyelinating lesion does not always herald a poor prognosis.
引用
收藏
页码:1710 / 1718
页数:9
相关论文
共 27 条
[1]   Atypical Acute Hemorrhagic Leukoencephalitis (Hurst's disease) Presenting with Focal Hemorrhagic Brainstem Lesion [J].
Abou Zeid, Nuhad E. ;
Burns, Joseph D. ;
Wijdicks, Eelco F. M. ;
Giannini, Caterina ;
Keegan, B. Mark .
NEUROCRITICAL CARE, 2010, 12 (01) :95-97
[2]   PERIVASCULAR IRON DEPOSITION AND OTHER VASCULAR DAMAGE IN MULTIPLE-SCLEROSIS [J].
ADAMS, CWM .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1988, 51 (02) :260-265
[3]  
BREITSCHOPF H, 1992, ACTA NEUROPATHOL, V84, P581
[4]   MONOCYTE-MACROPHAGE DIFFERENTIATION IN EARLY MULTIPLE-SCLEROSIS LESIONS [J].
BRUCK, W ;
PORADA, P ;
POSER, S ;
RIECKMANN, P ;
HANEFELD, F ;
KRETZSCHMAR, HA ;
LASSMANN, H .
ANNALS OF NEUROLOGY, 1995, 38 (05) :788-796
[5]   A pediatric patient of hemorrhagic acute transverse myelitis [J].
Fukuoka, Masataka ;
Kuki, Ichiro ;
Kawawaki, Hisashi ;
Kim, Kiyohiro ;
Hattori, Yuka ;
Tsuji, Hitomi ;
Horino, Asako ;
Nukui, Megumi ;
Okazaki, Shin .
BRAIN & DEVELOPMENT, 2017, 39 (03) :252-255
[6]   Atypical inflammatory demyelinating syndromes of the CNS [J].
Hardy, Todd A. ;
Reddel, Stephen W. ;
Barnett, Michael H. ;
Palace, Jacqueline ;
Lucchinetti, Claudia F. ;
Weinshenker, Brian G. .
LANCET NEUROLOGY, 2016, 15 (09) :967-981
[7]   HEMORRHAGIC COMPLICATIONS OF MULTIPLE-SCLEROSIS [J].
JANKOVIC, J ;
DERMAN, H ;
ARMSTRONG, D .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1980, 43 (01) :76-81
[8]   International Pediatric Multiple Sclerosis Study Group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions [J].
Krupp, Lauren B. ;
Tardieu, Marc ;
Amato, Maria Pia ;
Banwell, Brenda ;
Chitnis, Tanuja ;
Dale, Russell C. ;
Ghezzi, Angelo ;
Hintzen, Rogier ;
Kornberg, Andrew ;
Pohl, Daniela ;
Rostasy, Kevin ;
Tenembaum, Silvia ;
Wassmer, Evangeline .
MULTIPLE SCLEROSIS JOURNAL, 2013, 19 (10) :1261-1267
[9]  
KURTZKE JF, 1983, NEUROLOGY, V33, P1444, DOI 10.1212/WNL.33.11.1444
[10]   Acute Hemorrhagic Leukoencephalitis A Critical Entity for Forensic Pathologists to Recognize [J].
Lann, Meredith A. ;
Lovell, Mark A. ;
Kleinschmidt-DeMasters, B. K. .
AMERICAN JOURNAL OF FORENSIC MEDICINE AND PATHOLOGY, 2010, 31 (01) :7-11