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Cranial computed tomography in acute disseminated encephalomyelitis
1Department of Neurology, Chang Gung Memorial Hospital, Tapai, Taiwan, Republic of China.
Neuroradiology
|January 1, 1989
Summary
Acute disseminated encephalomyelitis (ADEM) is a rare nervous system inflammation. Cranial CT scans in seven patients revealed lesions and contrast enhancement, suggesting a dual pathogenesis responsive to steroids.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory neurological disorder.
- Cranial CT findings in ADEM are rarely documented.
- Understanding ADEM's imaging characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To report the cranial CT scan appearance of ADEM.
- To correlate imaging findings with clinical presentation and response to therapy.
- To explore the pathogenetic basis of ADEM based on imaging and treatment response.
Main Methods:
- Retrospective review of seven ADEM cases over seven years across two institutions.
- Analysis of cranial CT scans, including pre- and post-contrast imaging.
- Correlation of imaging findings with steroid treatment response and follow-up.
Main Results:
- Only four of seven patients exhibited hypodense white matter lesions on CT.
- Six patients showed spotty, nodular, or gyral enhancement post-contrast.
- Enhancement resolved with steroid therapy, but hypoattenuated areas persisted in some patients up to 10 months.
Conclusions:
- ADEM imaging findings suggest a dual pathogenesis involving a steroid-responsive vasculitic component and potentially non-responsive demyelinating/necrotic areas.
- Persistent hypoattenuated areas post-treatment may indicate sequelae related to demyelination or necrosis.
- CT imaging can provide insights into ADEM's pathophysiology and predict long-term outcomes.