Rhombencephalitis: pictorial essay.
The term rhombencephalitis refers to inflammatory diseases affecting the hindbrain (brainstem and cerebellum). Rhombencephalitis has a wide variety of etiologies, including infections, autoimmune diseases, and paraneoplastic syndromes. Infection with bacteria of the genusListeriais the most common cause of rhombencephalitis. Primary rhombencephalitis caused by infection withListeriaspp. occurs in healthy young adults. It usually has a biphasic time course with a flu-like syndrome, followed by brainstem dysfunction; 75% of patients have cerebrospinal fluid pleocytosis, and nearly 100% have an abnormal brain magnetic resonance imaging scan. However, other possible causes of rhombencephalitis must be borne in mind. In addition to the clinical aspects, the patterns seen in magnetic resonance imaging can be helpful in defining the possible cause. Some of the reported causes of rhombencephalitis are potentially severe and life threatening; therefore, an accurate initial diagnostic approach is important to establishing a proper early treatment regimen. This pictorial essay reviews the various causes of rhombencephalitis and the corresponding magnetic resonance imaging findings, by describing illustrative confirmed cases.
MD, Neuroradiologist at Hospital Moinhos de Vento and the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Líllian Gonçalves
LG
Campos
MD, Resident in Radiology and Diagnostic Imaging at the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Régis Augusto Reis
RA
Trindade
MD, Radiologist at Hospital Escola da Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
Ângela
Â
Faistauer
MD, Neuroradiologist at Hospital Moinhos de Vento and the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Juliano Adams
JA
Pérez
MD, Neuroradiologist at Hospital Moinhos de Vento and the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Leonardo Modesti
LM
Vedolin
PhD, MD, Neuroradiologist at the Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Juliana Ávila
JÁ
Duarte
Encephalitis; Magnetic resonance imaging; Rhombencephalon