title: MRI findings in acute Hendra virus meningoencephalitis.
abstract: OBJECTIVE
  To describe serial changes in brain magnetic resonance imaging (MRI) in acute human infection from two outbreaks of Hendra virus (HeV), relate these changes to disease prognosis, and compare HeV encephalitis to reported cases of Nipah virus encephalitis.
  
  
  METHODS
  The MRI images of three human cases (two of which were fatal) of acute HeV meningoencephalitis were reviewed.
  
  
  RESULTS
  Cortical selectivity early in the disease is evident in all three patients, while deep white matter involvement appears to be a late and possibly premorbid finding. This apparent early grey matter selectivity may be related to viral biology or ribavirin pharmacokinetics. Neuronal loss is evident at MRI, and the rate of progression of MRI abnormalities can predict the outcome of the infection. In both fatal cases, the serial changes in the MRI picture mirrored the clinical course.
  
  
  CONCLUSIONS
  This is the first comprehensive report of serial MRI findings in acute human cerebral HeV infection from two outbreaks. The cortical selectivity appears to be an early finding while deep white matter involvement a late, and possibly premorbid, finding. In both fatal cases, the serial changes in MRI mirrored the clinical course.
authors: Department of Diagnostic Radiology, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia.
authors: P
authors: P
authors: Nakka
authors: G J
authors: GJ
authors: Amos
authors: N
authors: N
authors: Saad
authors: S
authors: S
authors: Jeavons
mesh_terms: D000328:Adult; D000818:Animals; D001315:Australia; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000635:transmission; D017809:Fatal Outcome; D005260:Female; D045404:Hendra Virus; D006736:Horses; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis* / Q000635:transmission; D008875:Middle Aged; D045405:Nipah Virus; D011379:Prognosis; D055815:Young Adult