Viral encephalitis-MRI
The images show symmetrical bilateral putaminal vasogenic oedema with mild restriction on diffusion and no bleed.
The possibilities are
1.Methanol intoxication- should show bleed and opitc nerves involvement
2. Wilson disease- usually shows calcium to some extent apart from other basal ganglia ivolvement
3.Hypoxic ischaemic insults – should involve caudate and other graymatter nuclei
4. Leighs syndrome
5.Kearns-sayrnes syndrome
6. Striatal degeneration ass with lebers optic atrophy
7.Certain types of metabolic disorders
8.Carbonmonoxide poisoning-specially involves globus pallidus as well
9. Near drowning hypoxic anoxic injury
In our 4 yr old girl child, as the CSF is negative and she has staus epilepticus and other regions are not involved, slow viral disease causing encephalitis is possible. However classical SSPE should show starting from occipital cortex, then partietal and then other regions including basal ganglia, brainstem and post fossa white matter necrosis Imaging can be normal as well in SSPE. rpes encephalitis involves Temporal regions. Dengue, and Japanese B encephalitis usually involve thalami.
Case by Dr MGK Murthy, Sr Consultant Radiologist
Viral encephalitis-MRI
Reviewed by Sumer Sethi
on
Saturday, January 10, 2009
Rating:
Reviewed by Sumer Sethi
on
Saturday, January 10, 2009
Rating:
Sumer Sethi
Unique blend of academic excellence and entrepreneurship, heading leading firms in India- Teleradiology Providers, pioneering company providing teleradiology services and DAMS (Delhi Academy of Medical Sciences) Premier test preparation institute in India for MD/MS/MCI preparation. He has also been an invited faculty member at various conferences, including Teleradiology in IRIA 2008 and 2011, Hospital Build Middle East, Congress of the Brain Tumor Radiology in Neuro-oncology Society. Dr. Sethi is Editor-in-Chief of Internet Journal of Radiology. He has a keen interest in Web 2.0 technologies and in maintaining his famous radiology blog, which has been featured in multiple international journals.
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