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脑损伤时可发生急性肾小管坏死。动物实验证明,脑损伤时肾脏血管收缩,进而引起肾功能障碍。本文复习文献并报告两例颅内损伤引起的肾功能衰竭,两例均见肾血流减少及肾皮质外带肾小管坏死,而髓质旁肾单位则损伤轻微。例1,女,19岁,在两次癫痫大发作中发生急性肾功能衰竭。二次均有高渗性尿液,水排泄不良,说明肾浓缩能力仍存在。第二次发作后死亡。尸检发现肾皮质肾单位的肾小管坏死。脑左额顶区有两处血管瘤性血管畸形。例2,男,45岁,在3天的癫痫大发作中发生急性肾功能衰竭,表现为高渗尿液及水排泄不良,虽经透析疗法,病人仍死亡。尸检发现肾小管坏死,主要在皮质部,而髓质旁肾小管则完好。大脑皮层及部分皮层下有许多囊虫结节和钙化。
Acute tubular necrosis can occur during brain injury. Animal experiments show that when the brain injury, the kidneys vasoconstriction, which in turn lead to renal dysfunction. This article reviews the literature and reports two cases of renal failure caused by intracranial injury, renal blood flow was reduced in both cases and renal tubular necrosis of the renal cortex, while medullary nephron units were slightly damaged. Example 1, female, 19 years old, had acute renal failure in two episodes of epileptic seizures. Secondary hypertonic urine, water excretion, indicating that the ability of renal concentration still exists. After the second attack, he died. Autopsy revealed renal tubular necrosis of renal cortical nephrons. There are two hemangiomas in the left frontal area. Example 2 Male, 45 years old Acute renal failure occurred during a 3-day epileptic seizure characterized by hypertonic urine and water excretion. Despite dialysis therapy, the patient died. Autopsy found that renal tubular necrosis, mainly in the cortex, while medullary tubules are intact. There are many cystic nodules and calcifications in the cerebral cortex and part of the cortex.