[Reye syndrome evaluated by 99mTc-ECD SPECT: a case report].

We report a three-year-old boy with Reye syndrome evaluated by 99mTc-ECD SPECT. On acute stage, 99mTc-ECD brain SPECT disclosed diffuse high uptake in the cerebral cortex in spite of normal findings on brain X-ray CT. These lesions changed to general low uptake on the chronic state and multiple high intensity areas were shown on T2 weighted MRI image. Such a change of cerebral tracer uptake was considered to reflect the neuropathological change of Reye syndrome. 99mTc-ECD SPECT was a useful modality to diagnose Reye syndrome complementary.

[Clinical-instrumental dissociation in a case of Reye's syndrome]. / Dissociazione clinico-strumentale in un caso di sindrome di Reye.

We report the case of a boy 5 years old we admitted to our PICU with signs of impending hepatic failure (hypertransaminasemia, hyperammonemia, prolonged PT) following mild upper respiratory infection and irrepressible vomiting. We observed no neurological abnormalities excepting slight lethargy; on the contrary, EEG findings showed severe diffuse slowing and high-voltage Delta activity. Our diagnosis of Reye's syndrome was later confirmed by liver biopsy. Clinical and electrophysiological signs recovered after 48-72 hours and no explication was found for this anomalous Reye's syndrome presentation. Further studies are needed for understanding the basis of neurological involvement of stage I Reye's syndrome.

Symmetrical thalamic lesions on CT in influenza A virus infection presenting with or without Reye syndrome.

In Reye encephalopathy, diffuse brain swelling is a well known CT finding, but focal CT lesions have not been documented. We report 2 children with Reye encephalopathy and 2 children with non-Reye encephalopathy both associated with influenza A virus infection in whom symmetrical low density lesions of the thalamus and brainstem were detected on CT. These symmetrical low density lesions were present in the acute phase and decreased in size within a few weeks in all, and are still seen 2 years later as clearly defined small round areas in 3 surviving patients. Paired influenza A virus titers in blood showed 4-fold or more increase in all. Myelin basic protein (MBP) in CSF was increased in 2 of the 3 subjects studied. Liver biopsy showed diffuse lipid droplet infiltration in 2, focal infiltration in 1, and normal morphology in 1. The above data suggest that the symmetrical low density lesions were associated with influenza A virus infection, most likely consisting of edema, demyelination, and necrosis. We suspect that there is a continuum of Reye syndrome and virus-associated encephalopathy with significant overlap.

Acute toxic encephalopathy with symmetrical low density areas in the thalami and the cerebellum.

Unique CT findings were obtained in four cases of acute toxic encephalopathy, including two cases of clinical Reye's syndrome in the acute stage. Common findings in these cases were symmetrical low density in the thalami and the cerebellum (mainly the dentate nuclei) and similar changes in the surroundings of the lateral ventricles.

Reye syndrome associated with Hemophilus influenzae infection.

A case of Reye syndrome in an infant associated with culture-proven Hemophilus influenzae type d infection and probable meningitis is presented. This represents the second such reported case and the first to be described in detail. The criteria for the clinical and chemical diagnosis of Reye syndrome are reviewed. Pertinent and abnormal features of this patient's presentation are discussed. The finding of a non-visualizing liver on technetium-99m sulfur colloid isotope scan and possible mechanisms are discussed.

Reye syndrome: computed tomographic documentation of disordered intracerebral structure.

Four patients with well documented Reye syndrome were examined with noncontrast computed tomography. Acute findings are those of diffuse cerebral edema with low density in deep white matter, increased gray-white matter differentiation, and evidence of secondary ventricular compression. The diffuse nature of the changes is unlike the more focal pattern often seen in true viral encephalitis. Residual changes after severe diseases are those of nonspecific cerebral degeneration and are most pronounced in the frontal lobes. Atrophic ventricular dilatation was observed in two cases. Computed tomography findings correlate with all known pathologic studies and with the subsequent clinical courses in the patients examined.

Cerebral computed tomography in Reye syndrome.

The computed tomography (CT) findings in a case of Reye syndrome are presented. A striking discrepancy between the CT attenuation of infratentorial (elevated values) and supratentorial structures is observed.

Computerized tomography in Reye's syndrome: evidence for pathological cerebral vasodilatation.

The authors present two children with Reye's syndrome who were studied with serial computerized tomographic (CT) scanning. Scans performed with contrast enhancement during the acute phase of this disease showed evidence of pathological cerebral vasodilatation. The possible mechanism for this vasodilatation and the increased intracranial pressure (ICP) seen in Reye's syndrome are discussed.