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Acquired cerebral hemiatrophy: idiopathic?
Neeraj Kumar1, Edward P Lindell, John D Port
1Department of Neurology, Mayo Clinic, Rochester, MN, USA. kumar.neeraj@mayo.edu
Summary
This case study describes a young man with acquired cerebral hemiatrophy, possibly linked to an unidentified inflammatory or infectious condition. Further research may expand the understanding of Rasmussen
Area of Science:
- Neurology
- Neuroscience
- Medical Case Reports
Background:
- Acquired cerebral hemiatrophy is a rare neurological condition characterized by progressive unilateral brain atrophy.
- Etiologies are diverse, often involving vascular events, infections, or inflammatory processes.
- Rasmussen's encephalitis is a known cause, typically presenting with intractable epilepsy and cognitive decline.
Observation:
- A young male patient presented with initially progressive, then stabilizing, acquired cerebral hemiatrophy.
- The patient experienced no seizures during the illness.
- Extensive investigations failed to reveal a definitive cause, but cerebrospinal fluid analysis showed a mild pleocytosis during the progressive phase.
Findings:
- The clinical course and findings suggest an underlying unidentified infective or inflammatory process.
- The case challenges typical presentations of Rasmussen's encephalitis, suggesting it may represent a spectrum of disease.
- Multimodality imaging proved crucial in the diagnostic evaluation of cerebral hemiatrophy.
Implications:
- This case expands the potential spectrum of Rasmussen's encephalitis beyond typical epileptic presentations.
- Highlights the importance of considering inflammatory/infectious etiologies even without seizures in cerebral hemiatrophy.
- Underscores the value of advanced neuroimaging techniques in diagnosing complex neurological conditions.