カワジリ　スミヒロ   KAWAJIRI Sumihiro   河尻　澄宏    所属   医学部 医学科（附属東洋医学研究所）    職種   准教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Extensive hemispheric lesions with radiological evidence of blood-brain barrier integrity in a patient with neuromyelitis optica.
掲載誌名	正式名：Journal of the neurological sciences 略　 称：J Neurol Sci ISSNコード：18785883/0022510X
掲載区分	国外
巻・号・頁	284(1-2),pp.217-9
著者・共著者	Saiki Shinji, Ueno Yuji, Moritani Toshio, Sato Takeshi, Sekine Takeshi, Kawajiri Sumihiro, Adachi Satoshi, Yokoyama Kazumasa, Tomizawa Yuji, Motoi Yumiko, Hattori Nobutaka
発行年月	2009/09
概要	Anti-aquaporin-4 antibody (NMO-IgG) is used as a diagnostic marker for neuromyelitis optica (NMO). Although the mechanism of spinal cord lesions in NMO has been investigated, that of extensive hemispheric lesions with brain edema remains unclear. Here we report a 36-year-old woman with NMO positive for NMO-IgG, who developed an acute disseminating encephalomyelitis (ADEM)-like episode after Mycoplasma pneumoniae infection. Brain MRI T2-weighted images demonstrated asymmetric tumefactive hyperintense lesions in the subcortical white matter. Importantly, no lesions on T1-weighted images were enhanced after intravenous gadolinium administration on serial brain MRIs, suggesting preserved integrity of the blood-brain barrier (BBB). Likewise, the corresponding apparent diffusion coefficient maps demonstrated persistent hyperintensity changes, which represented vasogenic edema associated with glial damage and consequent neuronal loss. The findings suggest possible involvement of deficient water elimination associated with seropositivity to NMO-IgG in the induction of vasogenic edema even in the presence of intact and functional BBB.
DOI	10.1016/j.jns.2009.05.022
PMID	19497587