Serial diffusion-weighted imaging of neonatal herpes encephalitis: a case report.
We reported a patient with neonatal herpes simplex encephalitis in whom diffusion-weighted imaging was performed repeatedly. Diffusion-weighted imaging at 20h after the onset of seizures revealed scattered small spotty high intensity lesions in both hemispheres and a high intensity area in the left fronto-temporal lobe. There was no abnormal finding on conventional magnetic resonance imaging. Second diffusion-weighted imaging 72h after the onset revealed expanded scattered high intensity lesions in the bilateral hemisphere, a high intensity area in the left fronto-temporal lobe, and a new high intensity area in the right temporal lobe. There was no report on neonatal herpes simplex encephalitis that showed scattered high intensities in diffusion-weighted imaging. Scattered small high intensities on diffusion-weighted imaging may suggest endothelial cell infection with swelling and small vessel necrosis. Early diffusion-weighted imaging will be valuable for early detection and diagnosis of neonatal herpes simplex encephalitis.
Kubota
Tetsuo
T
Department of Pediatrics, Anjo Kosei Hospital, Aichi, Japan. t-kubota@kosei.anjo.aichi.jp
Ito
Miharu
M
Maruyama
Koichi
K
Kato
Yuichi
Y
Miyajima
Yuji
Y
Ogawa
Akimasa
A
Kuno
Kuniyoshi
K
Okumura
Akihisa
A
Watanabe
Kazuyoshi
K
D001921:Brain / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D004569:Electroencephalography; D020803:Encephalitis, Herpes Simplex / Q000151:congenital / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000209:etiology