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Acute encephalitis associated with measles: MRI features

K Y Lee1, W H Cho, S H Kim

  • 1Department of Radiology, Sanggye Paik Hospital, Inje University, 760-1 Sanggye-7 dong, Nowon-gu, Seoul 139707, Korea.

Neuroradiology
|February 20, 2003
PubMed

Insights

Magnetic resonance imaging (MRI) revealed characteristic brain changes in children with measles-related acute encephalitis. Key findings include cerebral hemisphere swelling and symmetrical involvement of deep gray matter structures, aiding diagnosis.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Measles can lead to acute encephalitis, a serious neurological complication.
  • Early diagnosis and understanding of imaging features are crucial for patient management.
  • Magnetic resonance imaging (MRI) plays a vital role in characterizing brain involvement.

Purpose of the Study:

  • To document and describe the specific MRI features observed in children with acute encephalitis following measles.
  • To correlate MRI findings with clinical presentation and serological diagnosis.

Main Methods:

  • Retrospective analysis of MRI scans from six pediatric patients (aged 5-14 years) diagnosed with measles encephalitis.
  • MRI sequences included T2-weighted imaging and diffusion-weighted imaging (DWI).
  • Clinical data, including rash onset and neurological symptoms, were correlated with imaging findings.

Main Results:

  • All patients exhibited widely distributed, multifocal high signal intensities on T2-weighted images in both cerebral hemispheres, with cortical swelling.
  • Bilateral and symmetrical involvement of the putamen and caudate nucleus was consistently observed.
  • Diffusion-weighted images showed restricted diffusion (low apparent diffusion coefficients), indicating cytotoxic edema. Three patients also showed subacute gyriform hemorrhage and contrast enhancement.

Conclusions:

  • MRI demonstrates characteristic patterns in measles-related acute encephalitis, including cerebral edema and basal ganglia involvement.
  • The presence of restricted diffusion and hemorrhage on MRI can indicate disease severity.
  • These imaging findings aid in the diagnosis and understanding of the pathophysiology of measles encephalitis in children.

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