RESUMO
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.
Assuntos
Humanos , Pessoa de Meia-Idade , Povo Asiático , Gânglios da Base , Encéfalo , Núcleo Caudado , Cerebelo , Córtex Cerebral , Doenças Transmissíveis , Difusão , Encefalite Japonesa , Ásia Oriental , Substância Cinzenta , Coreia (Geográfico) , Imageamento por Ressonância Magnética , Ponte , Núcleo Rubro , Substância Negra , Lobo Temporal , TálamoRESUMO
BACKGROUND: One of the characteristics of hypoglycemic encephalopathy (HE) is selective vulnerability of different brain regions. CASE REPORT: We observed a patient with unilateral HE affecting the right internal capsule and the subcortical white matter. The patient had a preexisting stroke in the opposite hemisphere. The hemisphere that was affected by HE exhibited greater regional blood flow (single positron-emission tomography) and higher fractional anisotropy (diffusion-tensor imaging) than the unaffected hemisphere. CONCLUSIONS: This case suggests that the degree of metabolism required to maintain the function of brain structures and neuronal integrity is an important factor determining the selective vulnerability in HE.