Multi-parametric magnetic resonance imaging in acute necrotizing encephalopathy of children: validity and prognostic value

Ibrahim, Rania S. M.; Elzayat, Wessam Abdelrahman; Seif, Hadeel; El-kiki, Hassan Ali; Emad‐Eldin, Sally; Shahin, M.; Kamel, Sara Mahmoud; Osama, Reham M.; Zakaryia, R.; Fatouh, Mona Mohammed; Hachem, Rania H.

doi:10.1186/s43055-020-00214-1

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…These imaging features are exemplified in Figures 1–4 above. Note that the previously described “classical neuroimaging” feature of DWI tricolor pattern or target-like lesions best seen on ACD maps is typically seen with larger lesions 8 and was not present in our case.…”

Section: Discussionsupporting

confidence: 52%

Recurrent acute hemorrhagic necrotizing encephalopathy associated with RAN-binding protein-2 gene mutation in a pediatric patient

et al. 2022

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A young male child presented with recurrent episodes of seizures and altered mental status following febrile episodes on three separate occasions between his first and third birthdays. Laboratory evaluations identified SARS-CoV-2 infection during the first episode and no infective agents or antibodies in the CSF during all the episodes. Brain imaging with CT and MRI revealed bilaterally symmetric patchy hemorrhagic necrotic foci in the deep brain nuclei and medial temporal lobes, prompting suspicion for an underlying predisposition to recurrent acute hemorrhagic necrotizing encephalopathy (rAHNE). Gene analysis confirmed a mutation in the RAN-Binding Protein-2 (RANBP2) gene. The patient made good recovery following treatment with IVIG, steroids and plasmapheresis, and follow-up brain imaging showed no progression of brain lesions. Early suspicion from characteristic imaging features in appropriate clinical settings will inform timely appropriate treatment and better outcome. We therefore provided short review of imaging features of AHNE.

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Section: Discussionsupporting

confidence: 52%

Recurrent acute hemorrhagic necrotizing encephalopathy associated with RAN-binding protein-2 gene mutation in a pediatric patient

et al. 2022

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“…It is characterized by the presence of symmetrical multifocal lesions with predominantly thalamic involvement, as well as the involvement of the brainstem, white matter of the brain, and cerebellum [3]. On tomography images, the lesions are hypodense with respect to the gray matter, and MRI shows a hypointense signal in T1, hyperintense in T2, hyperintense in FLAIR with internal hemorrhage plus restriction of the regions involved and with ring enhancement after administration of gadolinium [4][5].…”

Section: Introductionmentioning

confidence: 99%

Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult Patient: Case Report

Hernández-Dehesa

Alvarez-Castro

Aguilar-Hidalgo

et al. 2023

Preprint

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Purpose Show the MRI findings in a rare case of Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult PatientIntroduction Acute necrotizing encephalopathy is a rare condition characterized by the presence of symmetrical multifocal lesions with predominantly thalamic involvement, as well as involvement of the brainstem, white matter of the brain, and cerebellum.Case Presentation We describe a case of a 26-year-old male, with a medical history of medulloblastoma that was disease-free after treatment, and who tested positive in a PCR for SARS-CoV-2 in cerebrospinal fluid. Upon evaluation at the emergency department one week later, the patient was found to be awake, oriented, and focused, and could maintain attention for periods. Mixed dysarthria persisted, characterized by being flaccid and hypokinetic. On magnetic resonance imaging, there were multiple hemorrhagic lesions with surrounding edema in the right thalamus with an extension to the posterior arm of the internal capsule, a smaller one, in the left thalamus, and another expanded to the ipsilateral peduncle.Conclusion Acute necrotizing encephalopathy presents a great clinical and diagnostic challenge, Close clinical and radiological follow-up is essential, and magnetic susceptibility sequences (T2 or SWI) should be included in the diagnosis protocol.

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“…The tomography images reveal lesions with lower density compared to the gray matter, whereas MRI scans demonstrate a low-intensity signal in T1, a high-intensity signal in T2, and FLAIR sequences, along with internal hemorrhage and restricted regions involved. Furthermore, ring enhancement is observed after gadolinium administration [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult Patient: Case Report

Hernández-Dehesa

Alvarez-Castro

Aguilar-Hidalgo

et al. 2023

SN Compr. Clin. Med.

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To show the MRI findings in a rare case of acute necrotizing encephalopathy following SARS-CoV-2 infection in an adult patient. Acute necrotizing encephalopathy is a rare condition characterized by the presence of symmetrical multifocal lesions with predominantly thalamic involvement, as well as the brainstem and cerebellum. We describe the case of a 26-year-old male with a medical history of medulloblastoma that was disease-free after treatment and who tested positive in a PCR for SARS-CoV-2 in cerebrospinal fluid. Upon evaluation at the emergency department one week later, the patient was found to be awake, oriented, and focused and could maintain attention for periods of time. Mixed dysarthria persisted, characterized by being flaccid and hypokinetic. On magnetic resonance imaging, there were multiple hemorrhagic lesions with surrounding edema in the right thalamus with an extension to the posterior arm of the internal capsule, a smaller one in the left thalamus, and another expanded to the ipsilateral peduncle. Acute necrotizing encephalopathy presents a great clinical and diagnostic challenge, close clinical and radiological follow-up is essential, and magnetic susceptibility sequences (T2 or SWI) should be included in the diagnosis protocol.

show abstract

Multi-parametric magnetic resonance imaging in acute necrotizing encephalopathy of children: validity and prognostic value

Cited by 3 publications

References 23 publications

Recurrent acute hemorrhagic necrotizing encephalopathy associated with RAN-binding protein-2 gene mutation in a pediatric patient

Recurrent acute hemorrhagic necrotizing encephalopathy associated with RAN-binding protein-2 gene mutation in a pediatric patient

Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult Patient: Case Report

Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult Patient: Case Report

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