Complete right cerebral hemispheric diffusion restriction and its follow-up in a case of Rasmussen's encephalitis
| Autor: | Suresh Thirunavukarasu, Asthik Biswas, Farha Furruqh, Ravichandran Vivekandan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Rasmussen's encephalitis
Adult Male Status epilepticus Electroencephalography Article Cerebrospinal fluid Status Epilepticus medicine Effective diffusion coefficient Humans Cerebrum Brain Diseases medicine.diagnostic_test business.industry General Medicine medicine.disease Hyperintensity medicine.anatomical_structure Diffusion Magnetic Resonance Imaging Encephalitis Anticonvulsants medicine.symptom Atrophy Nuclear medicine business |
| Popis: | A 30-year-old man presented with generalised status epilepticus. Initial brain CT was normal (figure 1). His generalised seizures were controlled with antiepileptics. However, he continued to have left focal seizures. An MRI was performed showing diffuse T2 hyperintensity, oedema and high signal on diffusion-weighted imaging (DWI) with corresponding low signal on apparent diffusion coefficient (ADC) maps in the entire right cerebral hemisphere, implying restricted diffusion (figure 2A–C). Cerebrospinal fluid (CSF) analysis showed raised protein at 70 mg/dL and increased lymphocytes in cell count. CSF PCR for herpes simplex virus was negative. A working diagnosis of hemispheric demyelination was performed. The patient responded to intravenous methylprednisolone and was continued on oral steroids for 2 months. He was able to walk at the time of discharge with a power of 4 plus on the left. Figure 1 Normal brain CT at initial presentation. Figure 2 MRI in the acute phase of illness, taken 4 days after the brain CT study. (A) Axial T2-weighted image showing diffuse hyperintensity and oedema of the right cerebral hemisphere. (B) Diffusion-weighted image showing diffuse hyperintensity in the right cerebral … |
| Databáze: | OpenAIRE |
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