Magnetic Resonance Imaging of Idiopathic Herniation of the Lingual Gyrus: a Case Report

Idiopathic brain herniation is a rare condition. We believe that this is the first reported case of idiopathic herniation of the lingual gyrus. The case involves a 57-year-old woman presenting with frontal headache without overt visual symptoms. Magnetic resonance imaging (MRI) revealed an idiopathic herniation of the lingual gyrus of the occipital lobe extending into the quadrigeminal cistern. No other adjacent intracranial abnormalities were observed. Although some conditions may be considered in the differential diagnosis, accurate diagnosis of idiopathic brain herniation in medical practice can prevent unnecessary additional imaging procedures and invasive open biopsy in patients with typical imaging findings.

An Unusual Case of Japanese Encephalitis Involving Unilateral Deep Gray Matter and Temporal Lobe on Diffusion-Weighted MRI

Acute Japanese encephalitis (JE) is an endemic viral infectious disease in various parts of Far East and Southeast Asian countries including Korea. Bilateral thalami are the most common involving sites in JE. Other areas including the basal ganglia, substantia nigra, red nucleus, pons, cerebral cortex and cerebellum may be also involved. We report an extremely unusual brain diffusion-weighted MR imaging (DWI) findings in a 53-year-old man with serologically proven JE involving unilateral deep gray matter and temporal lobe, which shows multifocal high signal intensities in left thalamus, left substantia nigra, left caudate nucleus and left medial temporal cortex on T2-weighted image and DWI with iso-intensity on apparent diffusion coefficient (ADC) map.