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[A case of brain infarction associated with viral encephalitis: MRI and pathological findings]
M Koga1, T Hayashi, T Shinohara
1Department of Pediatrics, Yamaguchi University School of Medicine.
Abstract:
A 10-year-old girl had an infarction in the left brain during an acute viral meningoencephalitis. She initially showed seizure, unconsciousness and fever, and right hemiplegia gradually developed. She died at the 48th day of disease from respiratory disturbance and renal failure. Cranial MRI during the acute phase of the disease, when there was no clinical sign of right hemiplegia, showed a high intensity lesion in the left parietal and occipital areas on T-2 weight image. Autopsy disclosed the findings suggesting viral encephalitis, including multiple focal necrosis, perivascular round cell infiltration, proliferation of glial cells and spongy degeneration with some intranuclear inclusion bodies, and infarction in the left hemisphere. These findings suggest that T-2 high intensity lesion on MRI reflected infarction.
Insights
A pediatric case of acute viral meningoencephalitis led to left brain infarction. Cranial MRI revealed T-2 high intensity lesions correlating with autopsy-confirmed infarction, highlighting imaging
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Infectious Diseases
Background:
- Acute viral meningoencephalitis can present with severe neurological complications.
- Cerebral infarction is a potential sequela of severe encephalitis.
- Early detection of infarction is crucial for patient management.
Observation:
- A 10-year-old girl experienced seizure, unconsciousness, and fever due to viral meningoencephalitis.
- Right hemiplegia developed, and cranial MRI showed left parietal and occipital T-2 high intensity lesions.
- Autopsy confirmed viral encephalitis and left hemisphere infarction.
Findings:
- The T-2 high intensity lesions on MRI corresponded to the areas of infarction found during autopsy.
- Histopathological findings included focal necrosis, perivascular infiltration, glial proliferation, and intranuclear inclusion bodies consistent with viral encephalitis.
- The study links specific MRI findings to pathological evidence of infarction in a pediatric encephalitis case.
Implications:
- Cranial MRI, particularly T-2 weighted imaging, can detect early cerebral infarction in pediatric viral meningoencephalitis.
- These findings underscore the utility of neuroimaging in diagnosing complications of encephalitis.
- Understanding the imaging correlates of infarction in encephalitis can aid in prognosis and treatment strategies.