Atypical brain stem encephalitis associated with chronic subdural hematoma
| Autor: | Ryuta Suzuki, Goro Nagashima, Tomoo Chang, Jun-ichirou Asai, Hiromu Hokaku, Takayasu Miyo, Tsukasa Fujimoto |
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| Rok vydání: | 1998 |
| Předmět: | |
| Zdroj: | Nihon Kyukyu Igakukai Zasshi. 9:341-347 |
| ISSN: | 1883-3772 0915-924X |
| Popis: | A 47-year-old man was referred to our hospital under the diagnosis of chronic subdural hematoma. Initial symptoms upon admission were headache, vomiting, and mild consciousness disturbance. Given the diagnosis with bilateral occurrence, a burr hole and irrigation procedure was performed. However, the patient's consciousness disturbance worsened later. T2WI MRI revealed marked swelling of the brain stem with a high-intensity lesion within, which enlarged along with the consciousness exacerbation. Based on a clinical diagnosis of brain stem encephalitis, high-dose steroid therapy was administered. His consciousness level was restored to normal and the lesion on MRI decreased in size promptly. Brain stem encephalitis is conceived to be a disease which mainly affects the brain stem. It has not yet been defined by either mechanism or cause, but is basically diagnosed from clinical symptoms and pathological findings. There are two types: chronic type, which usually has a poor outcome; and acute progressive type, which is also known as Bickerstaff type. Brain stem encephalitis is not a common disease in the field of emergency medicine. In this case, the pattern of disease progression, the diagnostic procedure, and the roentgenographical changes were not typical of acute-type brain stem encephalitis. Further insight into the mechanisms of and accurate diagnostic methods for this disease are needed. |
| Databáze: | OpenAIRE |
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