Brain involvement in haemolytic-uraemic syndrome: MRI features of coagulative necrosis

We describe radiological demonstration of brain involvement in haemolytic-u raemic syndrome (HUS) in two siblings with a very different clinical course . While the brother presented with a mild, reversible encephalopathy, his s ister developed high-signal lesions in the cortex, putamen and caudate nucl eus on T1-weighted images, seen as dense areas on CT. Biopsy revealed coagu lative necrosis due to microthrombosis without haemorrhage, calcification o r infection. These findings suggest a possible prognostic role for MRI in c ases of encephalopathy due to HUS.