Dadak Mete, Pul Refik, Lanfermann Heinrich, Hartmann Hans, Hehr Ute, Donnerstag Frank, Michels Dirk, Tryc Anita Blanka
Department of Neuroradiology, Hannover Medical School, Carl-Neuberg-Str-1, 30625, Hannover, Germany.
Clinic for Neurology, University Hospital Essen, Essen, Germany.
Clin Neuroradiol. 2020 Jun;30(2):243-249. doi: 10.1007/s00062-018-0756-3. Epub 2019 Jan 4.
The brain imaging findings in children with neurological complications associated with influenza A infections are presented and analyzed and pathological imaging changes including atypical intracerebral hemorrhages in these patients are discussed.
Neuroimaging findings in six children with influenza encephalopathy following influenza A infection between 2012-2017 were retrospectively investigated. Of these five underwent magnetic resonance imaging (MRI) and one computed tomography (CT). Gene analysis was performed in two cases with acute necrotizing encephalitis of childhood (ANEC).
The MRI findings of one child were concordant with mild encephalopathy with a reversible splenial lesion (MERS); this patient recovered but remained aphasic. In two cases MRI showed typical bilateral thalamic lesions as a feature of ANEC; genetic testing facilitated the diagnosis in one case. One of the patients died, the other showed little improvement. The remaining three patients had multiple diffuse cerebral hemorrhages predominantly affecting the supratentorial white matter after influenza A infection complicated by pneumonia, rhabdomyolysis and sepsis requiring extracorporeal membrane oxygenation (ECMO).
Neurological complications in children associated with influenza A infection may include MERS and ANEC. Additionally, atypical disseminated intracerebral hemorrhages as a complication of influenza A infection is reported.
介绍并分析甲型流感感染相关神经并发症患儿的脑成像结果，并讨论这些患者包括非典型脑内出血在内的病理成像变化。
回顾性研究2012年至2017年间6例甲型流感感染后发生流感性脑病患儿的神经影像学表现。其中5例接受了磁共振成像（MRI）检查，1例接受了计算机断层扫描（CT）检查。对2例儿童急性坏死性脑病（ANEC）患者进行了基因分析。
1例患儿的MRI表现与伴有可逆性胼胝体病变的轻度脑病（MERS）相符；该患者康复但仍失语。2例MRI显示典型的双侧丘脑病变，为ANEC的特征；基因检测有助于1例的诊断。其中1例患者死亡，另1例改善甚微。其余3例患者在甲型流感感染并发肺炎、横纹肌溶解和败血症并需要体外膜肺氧合（ECMO）后，出现多处弥漫性脑出血，主要影响幕上白质。
甲型流感感染相关儿童神经并发症可能包括MERS和ANEC。此外，还报告了甲型流感感染并发症非典型性播散性脑内出血。
