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Updated: Feb 19, 2026
High-Resolution 3D Imaging of Rabies Virus Infection in Solvent-Cleared Brain Tissue
Published on: April 30, 2019
Serial brain MRI findings in a rare survivor of rabies encephalitis
Akhilesh Rao1, Yayati Pimpalwar1, Arindam Mukherjee2
1Department of Radiodiagnosis and Imaging, Command Hospital (CC), Lucknow, Uttar Pradesh, India.
Abstract:
Rabies is a neurotropic viral illness, almost always fatal, that is equally dreaded by healthcare practitioners and patients due to the dismal prognosis and limited treatment options once symptoms set in. There are hardly any reports on MRI changes in the brain in survivors of rabies encephalitis. We present the clinical course and the imaging findings on serial MRI examinations in a rare patient who survived rabies infection. Initial brain MRI done 8 days after onset of symptoms revealed bilaterally symmetrical non-enhancing areas of T1 and T2 hyperintensity in the basal ganglia, thalami, mid brain, and pons along with T2 hyperintensity and restricted diffusion in fronto-parietal cortical grey matter and left hippocampus. Subsequent MRI scans at 2 months and 5 months revealed progressive brain atrophy, leukoencephalopathy, and gliosis.
Insights
This study details the rare case of a rabies encephalitis survivor, highlighting initial and progressive brain MRI changes. Findings reveal symmetrical lesions in deep grey matter and cortical areas, followed by atrophy and leukoencephalopathy.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Rabies is a fatal neurotropic viral illness with limited treatment options.
- Few studies document MRI findings in rabies encephalitis survivors.
- Understanding neuroimaging in survivors is crucial for prognosis and management.
Purpose of the Study:
- To present the clinical course and serial MRI findings in a rare survivor of rabies encephalitis.
- To document the evolution of brain lesions in a rabies survivor.
Main Methods:
- Serial magnetic resonance imaging (MRI) examinations were performed on a patient who survived rabies infection.
- Imaging analysis focused on characterizing lesion location, signal intensity, enhancement patterns, and diffusion characteristics.
- Clinical course and follow-up imaging over five months were documented.
Main Results:
- Initial MRI showed symmetrical T1 and T2 hyperintensities in basal ganglia, thalami, midbrain, and pons, with cortical and hippocampal involvement.
- These lesions were non-enhancing but showed restricted diffusion in cortical areas.
- Follow-up MRIs revealed progressive brain atrophy, leukoencephalopathy, and gliosis.
Conclusions:
- Rabies encephalitis can lead to significant, progressive neuroimaging abnormalities even in survivors.
- Serial MRI is valuable for tracking the neuropathological changes associated with rabies infection.
- This case expands the understanding of neuroimaging manifestations in rabies survivors.
