Mori Koichiro, Yagishita Akira, Funata Nobuaki, Yamada Ryoji, Takaki Yasunobu, Miura Yoshiharu
Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Radiol Case Rep. 2022 Sep 26;17(12):4481-4486. doi: 10.1016/j.radcr.2022.08.084. eCollection 2022 Dec.
Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease and may sometimes present with symptoms of subacute encephalopathy, including fever, headache, vomiting, and loss of consciousness. We present a case of adult-onset NIID with subacute encephalopathy, which is confirmed by skin and brain biopsied. The magnetic resonance imaging findings show cortical swelling and hyperintensities in the right temporooccipital lobes on T2-weighted images and magnetic resonance angiography demonstrates vasodilatations of the right middle cerebral artery and posterior cerebral artery. Abnormal enhancement is mainly observed in the gyral crowns (crown enhancement). Pathological examinations reveal new infarcts in the deep layers of the cortices. NIID should be considered in the presence of subacute encephalopathy with cortical swelling, contrast enhancement in the temporooccipital lobes, and vasodilation in adult patients. The encephalopathy targeted on the cortices, and the pathological background included infarctions.
神经元核内包涵体病(NIID)是一种缓慢进展的神经退行性疾病,有时可能表现为亚急性脑病症状,包括发热、头痛、呕吐和意识丧失。我们报告一例成年起病的伴有亚急性脑病的NIID病例,该病例经皮肤和脑活检确诊。磁共振成像结果显示,在T2加权图像上右侧颞枕叶皮质肿胀且信号增强,磁共振血管造影显示右侧大脑中动脉和大脑后动脉血管扩张。异常强化主要见于脑回顶部(顶部强化)。病理检查显示皮质深层有新的梗死灶。成年患者出现伴有皮质肿胀的亚急性脑病、颞枕叶对比增强和血管扩张时,应考虑NIID。该脑病以皮质为靶点,病理背景包括梗死。