A. Yagishita et al., ACUTE ENCEPHALOPATHY WITH BILATERAL THALAMOTEGMENTAL INVOLVEMENT IN INFANTS AND CHILDREN - IMAGING AND PATHOLOGY FINDINGS, American journal of neuroradiology, 16(3), 1995, pp. 439-447
Citations number
35
Categorie Soggetti
Neurosciences,"Radiology,Nuclear Medicine & Medical Imaging
PURPOSE: To investigate the imaging and pathologic characteristics of
acute encephalopathy with bilateral thalamotegmental involvement in in
fants and children. METHODS: Five Japanese children ranging in age fro
m 11 to 29 months were studied. We performed CT imaging in all patient
s, 10 MR examinations in four patients, and an autopsy in one patient.
RESULTS: The encephalopathy affected the thalami, brain stem tegmenta
, and cerebral and cerebellar white matter, The brain of the autopsied
case showed fresh necrosis and brain edema without inflammatory cell
infiltration, Petechiae and congestion were demonstrated mainly in the
thalamus. CT and MR images showed symmetric focal lesions in the same
areas in the early phase, These lesions became more demarcated and sm
aller in the intermediate phase. The ventricles and cortical sulci enl
arged. MR images demonstrated T1 shortening in the thalami. The progno
sis was generally poor; one patient died, three patients were left wit
h severe sequelae, and only one patient improved. CONCLUSIONS: The enc
ephalopathy might be a postviral or postinfectious brain disorder, T1
shortening in the thalami indicated the presence of petechiae.