A pediatric patient of hemorrhagic acute transverse myelitis

Fukuoka, Masataka; Kuki, Ichiro; Kawawaki, Hisashi; Kim, Kiyohiro; Hattori, Yukio; Tsuji, Hitomi; Horino, Asako; Nukui, Megumi; Okazaki, Shin

doi:10.1016/j.braindev.2016.09.007

Cited by 5 publications

(2 citation statements)

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“…There were no patients in our cohort with myelin oligodendrocyte glycoprotein antibody-associated disease, or aquaporin-4 IgG-positive neuromyelitis optica spectrum disorder (NMOSD), nor were there haemorrhagic demyelinating spinal cord lesions, although these have been described by others. 18,19 Defining the difference between ADEM and AHL on clinical grounds is difficult. AHL is held to be a rapidly fatal disease associated with haemorrhagic demyelinating lesions, but no patient in our cohort died from their 'AHL'.…”

Section: Discussionmentioning

confidence: 99%

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The clinical spectrum of haemorrhagic CNS inflammatory demyelinating lesions

et al. 2022

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Background: Haemorrhagic demyelinating lesions are rare, and little is known about the demyelinating diseases with which they are associated, or how lesional haemorrhage affects treatment and outcomes. Objective: To examine the clinical characteristics and outcomes of patients with demyelinating lesions and magnetic resonance imaging (MRI) evidence of haemorrhage seen at the Mayo clinic between 1990 and 2018. Methods: The Mayo Clinic’s medical-record diagnostic-linkage system was used to identify patients with CNS demyelinating disease and parenchymal haemorrhage on brain MRI cross-referenced against a database of patients with pathologically confirmed CNS demyelinating disease. The clinical characteristics, diagnosis, MRI findings, brain histopathology, and outcomes of these patients were reviewed. Results: Ten patients with haemorrhagic demyelination were identified, including three patients who underwent a brain biopsy. The main findings were that haemorrhagic demyelinating lesions most often occur in atypical forms of demyelination, especially acute haemorrhagic leukoencephalitis (AHL, or Weston–Hurst disease) and tumefactive demyelination, and rarely in multiple sclerosis. A spectrum of outcomes was observed for these patients ranging from complete remission through to high level disability. Conclusion: Lesional haemorrhage is uncommon in demyelinating disease where it is most closely associated with AHL. Bleeding within a demyelinating lesion does not always herald a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%