Yagishita A, Nakano I, Ushioda T, Otsuki N, Hasegawa A
Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, Japan.
AJNR Am J Neuroradiol. 1995 Mar;16(3):439-47.
To investigate the imaging and pathologic characteristics of acute encephalopathy with bilateral thalamotegmental involvement in infants and children.
Five Japanese children ranging in age from 11 to 29 months were studied. We performed CT imaging in all patients, 10 MR examinations in four patients, and an autopsy in one patient.
The encephalopathy affected the thalami, brain stem tegmenta, and cerebral and cerebellar white matter. The brain of the autopsied case showed fresh necrosis and brain edema without inflammatory cell infiltration. Petechiae and congestion were demonstrated mainly in the thalamus. CT and MR images showed symmetric focal lesions in the same areas in the early phase. These lesions became more demarcated and smaller in the intermediate phase. The ventricles and cortical sulci enlarged. MR images demonstrated T1 shortening in the thalami. The prognosis was generally poor; one patient died, three patients were left with severe sequelae, and only one patient improved.
The encephalopathy might be a postviral or postinfectious brain disorder. T1 shortening in the thalami indicated the presence of petechiae.
探讨婴幼儿双侧丘脑被盖部受累的急性脑病的影像学及病理特征。
对5名年龄在11至29个月的日本儿童进行研究。所有患者均行CT检查，4名患者行10次磁共振检查，1名患者进行了尸检。
脑病累及丘脑、脑干被盖部、大脑及小脑白质。尸检病例的脑部显示新鲜坏死及脑水肿，无炎性细胞浸润。瘀点和充血主要见于丘脑。CT和磁共振图像在早期显示相同区域的对称性局灶性病变。在中期，这些病变边界更清晰且变小。脑室和脑沟增宽。磁共振图像显示丘脑T1缩短。总体预后较差；1例患者死亡，3例患者留有严重后遗症，仅1例患者病情好转。
该脑病可能是一种病毒感染后或感染后脑病。丘脑T1缩短提示存在瘀点。
