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Hemolytic uremic syndrome: MR findings of CNS complications
1Department of Radiology, Seoul National University Children's Hospital, Chongno-gu, Korea.
Abstract:
MR findings of a patient with hemolytic uremic syndrome involving the CNS are described. Abnormal high signal intensity on T2-weighted images combined with swelling in the lentiform nucleus, posterior limb of internal capsule, external capsule bilaterally, and left extreme capsule was shown on initial MR; a small low signal intensity in the left putamen on T1- and T2-weighted images and generalized atrophy in the area of high signal intensity on previous T2-weighted images was shown on follow-up MR. These findings indicate infarct with focal hemorrhage, which is one of the histopathological features of CNS complication in hemolytic uremic syndrome.
Insights
Hemolytic uremic syndrome (HUS) can affect the central nervous system (CNS). MR imaging reveals infarcts with hemorrhage in the brain, a key feature of CNS complications in HUS.
Area of Science:
- Neurology
- Radiology
- Pediatric Nephrology
Background:
- Hemolytic uremic syndrome (HUS) is a serious condition often associated with infections.
- Central nervous system (CNS) involvement in HUS can lead to severe neurological deficits.
Observation:
- Initial MR imaging demonstrated T2-weighted hyperintensities and swelling in specific brain regions, including the lentiform nucleus, internal and external capsules, and extreme capsule.
- Follow-up MR revealed a small hypointense signal in the left putamen on T1- and T2-weighted images.
- Generalized atrophy was observed in areas previously showing high signal intensity on T2-weighted images.
Findings:
- The observed MR findings are indicative of infarct with focal hemorrhage.
- These imaging characteristics are consistent with histopathological features of CNS complications in hemolytic uremic syndrome.
Implications:
- Early recognition of these MR findings is crucial for diagnosing CNS involvement in HUS.
- Understanding these imaging patterns aids in predicting neurological outcomes for patients with HUS.