[Clinical and computer tomographic diagnosis of necrotic encephalitis]

Twenty-five patients with a suspicion of necrotic encephalitis were examined by computer-aided tomography (CT). Brain tumors were detected in 5 patients. Three patients had negative results of CT examination and later other etiology was established in these cases. Fifteen patients showed characteristic foci of diminished density in the cerebral substance; in 3 cases necrosis was verified postmortem. The time-course of the encephalitis process was traced in the majority of patients. The diagnosis based on laboratory findings made it possible to confirm the etiological role of herpes simplex virus in the development of encephalitis in 2 patients with negative results of CT examinations. Possible causes of the negative results are discussed. Possible involvement of the lenticular nuclei, the brain stem and the cerebellum in necrotic encephalitis is demonstrated. The method is recommended for the early diagnosis of necrotic encephalitides.