Spectrum of findings on magnetic resonance imaging of the brain in patients with neurological manifestations of dengue fever

Abstract

ObjectiveTo describe the spectrum of magnetic resonance imaging (MRI) findings in patients with neurological manifestations of dengue.Materials and MethodsWe included nine patients with dengue fever (three females and six males; age range, 9–30 years), all of whom presented with neurological manifestations. The MRI examinations, performed in 1.5 T or 3 T scanners, included T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion-weighted imaging with apparent diffusion coefficient mapping was also employed. Fast low-angle shot and susceptibility-weighted gradient-recalled echo sequences, as well as contrast-enhanced T1-weighted scans, were also obtained in order to assess parenchymal enhancement. MRI scans were analyzed for lesion distribution and imaging features.ResultsAll patients showed areas of altered signal intensity that appeared as hyperintensity on T2-weighted and FLAIR sequences. The most commonly affected site was the basal ganglia-thalamus complex. Other affected sites were the cerebellum, cerebral cortex, white matter, and brainstem. In all cases, we observed patchy areas of restricted diffusion and focal areas of hemorrhage.ConclusionDengue encephalitis commonly affects the basal ganglia, thalamus, cerebellum, cerebral cortex, and white matter. Therefore, MRI should be an indispensable part of the evaluation of patients with neurological complications of dengue fever.

Case Report: Right Hemispheric Neuroimaging Abnormalities in a Patient with Dengue Encephalopathy

“…10 However, imaging abnormalities, if present, usually involve periventricular structures such as basal ganglion, thalamus, and periventricular white matter. 11 Common magnetic resonance imaging abnormalities are hyperintensities in bilateral cerebral parenchyma, including basal ganglia, detected in T2 and fluid-attenuated inversion recovery sequences. 12 In our case, it is difficult to explain the cause of unilateral imaging abnormalities in our patient that mimicked middle cerebral artery infarct but without any focal deficit.…”

A Case Report on Dengue Encephalitis With Optic Neuropathy

“…MRI is preferred over CT scan for neuroimaging, and findings are usually non-specific [5]. Nevertheless, abnormal signal intensities, patchy areas of restricted diffusion, focal hemorrhages, and subtle enhancement after contrast administration have been reported [10]. The basal ganglia and thalamus, followed by the cerebral and cerebellar cortices, are most commonly affected.…”

Neurologische Bildgebung bei neu oder wieder vermehrt auftretenden Infektionen

“…Diese reichen von einer asymptomatischen oder leicht symptomatischen Virämie bis hin zu schweren neurologischen und nicht neurologischen Komplikationen, die letzten Endes tödlich verlaufen können [22,24,25]. Da sich einige der klinischen Merkmale von Arbovirusinfektionen überschneiden, können neuroradiologische Befunde, epidemiologische Informationen, klinische Profile und Liquoranalysen dazu beitragen, die jeweiligen Infektionen voneinander abzugrenzen [22,24,26].…”

“…Infektionen mit dem Dengue-Virus werden durch Stechmücken übertragen und treten zumeist in urbanen und suburbanen Räumen in tropischen oder subtropischen Regionen der Welt auf [26,27]. Beim Dengue-Virus handelt es sich um ein RNA-Virus aus der Gattung Flavivirus und der Familie der Flaviviridae.…”