目的　了解海洛因海绵状白质脑病的临床特征、治疗及预后。方法　观察 2例海洛因海绵状白质脑病患者的临床、影像学表现及治疗转归 ,并结合文献进行分析。结果　 2例均为中年男性 ,有烫吸海洛因病史 ,其中 1例尚有静脉注射史。1例以反应迟钝、行为异常为首发症状 ;1例以小脑症状为突出表现。头颅MRI均表现为脑白质广泛病变 ,其中 1例影像学显示小脑中线两旁、边界清楚的对称性类圆形或蝴蝶样病灶及内囊后肢对称性受损等特征性改变。经促进脑细胞代谢药物等治疗后 ,随访 2年均恢复良好。结论　海洛因海绵状白质脑病是一种少见的与海洛因相关的特征性脑部病变 ,及时诊治 ,预后较好。 Objective To understand the clinical features, treatment and prognosis of heroin cavernous leukoencephalopathy. Methods Two cases of heroin cavernous leukoencephalopathy were observed in clinical, radiographic manifestations and treatment outcome, and the literature was analyzed. Results Both of the two cases were middle-aged men. They had a history of heroin abuse. Among them, 1 had intravenous injection history. 1 case of unresponsive, abnormal behavior as the first symptom; 1 case of cerebellar symptoms as a prominent manifestation. Head MRI showed extensive white matter lesions, including 1 case of imaging showed that the bilateral cerebellar midline, a clear boundary symmetry round or butterfly-like lesion and symmetry of the internal capsule hind limb lesions and other changes. After the promotion of brain cell metabolism drugs and other treatment, were followed up for 2 years were recovered well. Conclusion Heroin spongiform encephalopathy is a rare heroin-related characteristic brain disease, timely diagnosis and treatment, the prognosis is good.