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Cortical laminar necrosis in dengue encephalitis-a case report
Ravindra Kumar Garg1, Imran Rizvi2, Rajan Ingole2
1Department of Neurology, King George's Medical University, UP, Lucknow, 226003, India. garg50@yahoo.com.
BMC Neurology
|April 22, 2017
Summary
This study highlights a rare case of dengue encephalitis in a 15-year-old boy, identifying cortical laminar necrosis on MRI as a key indicator of this severe dengue complication.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Dengue encephalitis is a rare but serious neurological complication of dengue fever.
- Its presentation mimics other viral encephalitides, lacking specific MRI findings.
- Magnetic resonance imaging (MRI) findings in dengue encephalitis are typically variable and atypical.
Observation:
- A 15-year-old male presented with fever, headache, and altered sensorium.
- Laboratory tests showed leukopenia and thrombocytopenia, with positive dengue virus IgM in serum and CSF.
- Neurological examination revealed a Glasgow Coma Scale score of 10 without focal deficits.
Findings:
- Brain MRI demonstrated signal changes in the parietooccipital and left frontal regions.
- Gyriform enhancement in the parietooccipital regions indicated cortical laminar necrosis.
- Subcortical white matter involvement and basal ganglia T2 hyperintensity were observed, with evidence of hemorrhage on gradient echo sequences.
Implications:
- This case presents an unusual MRI finding of cortical laminar necrosis in dengue encephalitis.
- Recognizing this specific MRI pattern could aid in diagnosing dengue encephalitis.
- Early diagnosis and management are crucial for improving patient outcomes in severe dengue cases.
