Extensive vasogenic edema of anti-aquaporin-4 antibody-related brain lesions.
OBJECTIVE
Using neuroimaging, we analyzed the nature of extensive brain lesions in five anti-aquaporin-4 (AQP4) antibody-positive patients with neuromyelitis optica spectrum disorders.


RESULTS
Extensive brain lesions involved white matter in three, and basal ganglia and corpus callosum in one each. Four patients showed high diffusivity on apparent diffusion coefficient maps and three demonstrated increased choline/creatine ratios and decreased N-acetyl-aspartate/creatine ratios on (1)H-magnetic resonance spectroscopy. These findings suggested that the lesions were vasogenic edema associated with inflammation. Unusual brain symptoms associated with such lesions included recurrent limbic encephalitis, parkinsonism, and coma.


CONCLUSIONS
Anti-AQP4 antibody is considered to be associated with the neuroimaging appearances of vasogenic edema.
Matsushita
T
T
Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Isobe
N
N
Matsuoka
T
T
Ishizu
T
T
Kawano
Y
Y
Yoshiura
T
T
Ohyagi
Y
Y
Kira
J
J
D000328:Adult; D051401:Aquaporin 4 / Q000378:metabolism*; D001479:Basal Ganglia / Q000378:metabolism / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism*; D001929:Brain Edema / Q000378:metabolism* / Q000473:pathology*; D003337:Corpus Callosum / Q000378:metabolism / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000378:metabolism* / Q000473:pathology*
C496030:AQP4 protein, human; D051401:Aquaporin 4; D015415:Biomarkers