A31yearoldmanfo



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A31-year-oldmanfoundunresponsive.

A

B

C

Whatisyourdiagnosis?

TheanswerisHerpesSimplexEncephalitis

Herpessimplexvirus(HSV)encephalitisisgenerallythoughttooccurasaformofreactivationofHSV-1virusintheganglionofthetrigeminalnerve,whichsubsequentlytravelsalonganerveaxontothebrain.

T2-weightedFLAIRMRI(figuresAandB)revealshyperintensitycorrespondingtoedematouschangesinthetemporallobes,inferiorfrontallobes,andinsula,withapredilectionforthemedialtemporallobes.

TheT2hyperintensityreflectscytotoxicedemaasshownwithrestricteddiffusiononDWI(figureC).

Typically,thebasalgangliaarespared.

中文版:

男性,31岁,发现无反应

诊断:单纯疱疹病毒性脑炎

单纯疱疹病毒性脑炎通常认为是因三叉神经节处的单纯疱疹病毒1型重新活化,并通过神经轴索播散至脑内而引起。

病变于MRIT2FLAIR像(A,B图)表现为颞叶、额叶底部以及岛叶异常高信号,尤其好发于颞叶内侧,提示为水肿改变。

T2WI表现为高信号,DWI表现为弥散受限,表明病变区域为细胞毒性水肿(C图)。

双侧基底节区通常不受累及。

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