Thrombocytopenic thrombotic purpura: severe clinic with no CT, minor MRI, but a SPECT correlate.
A 28-year-old woman with primarily therapy refractory TTP was followed neuroradiologically over 6 months. Despite pronounced neurological and neuropsychiatric symptoms including hemiparesis and aphasia she had unremarkable CT scans on two occasions. Three MRI exams showed no correlate for her neurological symptoms except a small petechial cortical hemorrhage in the right parietooccipital gyrus which may account for her TTP-related anxiety disorder. A cerebral HMPAO-SPECT showed long-standing right-sided hypoperfusion compatible with residual vasculature changes. The possible causes for the clinico-neuroradiological discrepancies are discussed in view of the literature.
Baron
Y
Y
Radiologische Abteilung, Städtisches Krankenhaus Kiel, Germany. yvonne_baron@radiology.ucsf.edu
Bargemann
T
T
Harten
P
P
Gutschmidt
H J
HJ
D000328:Adult; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous; D008279:Magnetic Resonance Imaging; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis* / Q000628:therapy; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D016756:Immunoglobulins, Intravenous