Prediction of Clinical Course of Herpes Simplex Encephalitis from Magnetic Resonance Imaging –⁠ a Case Report

Czech version

Authors: T. Viták ^1,2; Z. Seidl ^1,2; M. Vaněčková ^1,2; Andrea Burgetová ^1,2; P. Pokorná ³
Authors‘ workplace: Radiodiagnostická klinika, oddělení MR, 1. LF UK a VFN v Praze ¹; Vysoká škola zdravotnická, Praha ²; Klinika dětského a dorostového lékařství 1. LF UK a VFN v Praze ³
Published in: Cesk Slov Neurol N 2009; 72/105(1): 77-81
Category: Case Report

Overview

Three case reports support evidence that MRI is a valuable tool for herpes simplex encephalitis detection if diffusion-weighted MR imaging is used. Authors present a hypothesis on predictive power of MRI. Pathological findings in DWI complemented with normal picture of “conventional” MRI sequences are suggestive of future necrotic encephalitis with bad prognosis.

Key words:
herpetic encephalitis –⁠ magnetic resonance imaging –⁠ diffusion weighted image –⁠ clinical progression

Sources

1. Lipkin WI. European consensus on viral encephalitis. Lancet 1997; 349(9048): 299–300.

2. Domingues RB, Fink MC, Tsanaclis AM, de Castro CC, Cerri GG, Mayo MS et al. Diagnosis of herpes simplex encefalitis by magnetic resonance imaging and polymerase chain reaktion assay of cerebrospinal fluid. J Neurol Sci 1998; 157(2): 148–153.

3. Schmutzhard E. Viral infections of the CNS with special emphasis on herpes simplex infections. J Neurol 2001; 248(6): 469–477.

4. Fomsgaard A, Kirkby N, Jensen IP, Vestergaard BF. Routine diagnosis of herpes simplex virus (HSV) encephalitis by an internal DNA controlled HSV PCR and an IgG-capture assay for intrathecal synthesis of HSV antibodies. Clin Diagn Virol 1998; 9(1): 45–56.

5. Li TQ, Takahashi AM, Hindsmarsh T, Moseley ME. ADC mapping by means of single shot spiral MRI technique with application in acute cerebral ischemia. Magn Reson Med 1999, 41(1), 143–147.

6. Rowley HA, Grant PE, Roberts TP. Diffusion MR imaging. Theory and applications. Neuroimaging Clin N Am 1999; 9(2): 343–361.

7. Warach S, Chien D, Li W, Ronthal M, Edelman RR. Fast magnetic resonance diffusion-weighted imaging of acute human stroke. Neurology 1992; 42(9): 1717–1723.

8. Warach S, Gaa J, Siewert B, Wielopolski P, Edelman RR. Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 1995; 37(2): 231–241.

9. Heiner L, Demaerel PH. Diffusion-weighted MR imaging findings in patient with herpes simplex encephalitis. Eur J Radiol 2003; 45(3): 195–198.

10. Küker W, Nägele T, Schmidt F, Heckl S, Herrlinger U. Diffusion-weighted MRI in herpes simplex encefalitis: a report of three cases. Neuroradiology 2004; 46(2): 122–125.

11. Sener RN. Herpes simplex encephalitis: diffusion MR imaging findings. Comput Med Imaging Graph 2001; 25(5): 391–397.

12. Uluğ AM, Moore DF, Bojko AS, Zimmerman RD. Clinical use of diffusion-tensor imaging for diseases causing neuronal and axonal damage. AJNR Am J Neuroradiol 1999; 20(6): 1044–1048.

13. Kubota T, Ito M, Maruyama K, Kato Y, Miyajima Y, Ogawa A et al. Serial diffusion-weighted imaging of neonatal herpes encephalitis: a case report. Brain Dev 2007; 2(3): 171–173.