Document Detail


Acute hemorrhagic leukoencephalitis with severe brainstem and spinal cord involvement: MRI features with neuropathological confirmation.
MedLine Citation:
PMID:  21448963     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Acute hemorrhagic leukoencephalitis (AHLE) is a rare and fulminant demyelinating disease considered to be the most severe form of acute disseminated encephalomyelitis (ADEM). A 70-year-old man was admitted to our emergency department (ED) after 1 week of unspecific abdominal symptoms and moderate fever in the first 3 days. Within the ED he developed a rapid onset coma and flaccid tetraparesis. Cerebrospinal fluid (CSF) analysis showed mild polymorphonuclear pleocytosis and magnetic resonance imaging (MRI) revealed supratentorial focal white matter lesions and diffuse involvement of the medulla and spinal cord. A presumptive diagnosis of ADEM was made and the patient was treated with corticosteroids followed by intravenous immunoglobulin. His neurological state did not improve and the MRI on day 8 after admission showed an increased number of lesions, mainly in the brainstem, with hemorrhagic foci. The patient died the following day and pathological features confirmed the diagnosis of AHLE. This is a unique presentation of a rare disease with detailed MRI characteristics and pathological confirmation. Although this condition is usually fatal, early recognition and aggressive therapeutic management can facilitate survival. J. Magn. Reson. Imaging 2011;33:957-961. © 2011 Wiley-Liss, Inc.
Authors:
Pedro S Pinto; Ricardo Taipa; Bruno Moreira; Carlos Correia; Manuel Melo-Pires
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  33     ISSN:  1522-2586     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  957-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley-Liss, Inc.
Affiliation:
Neuroradiology Department, Centro Hospitalar do Porto, Porto, Portugal. p@pinto.as.
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