J Korean Soc Radiol.  2016 Feb;74(2):142-146. 10.3348/jksr.2016.74.2.142.

Numerous Cerebral Hemorrhages in a Patient with Influenza-Associated Encephalitis: A Case Report

• Lee JY
• Seong SO
• Park NH
• Park CS

• KMID: 2152608
• DOI: http://doi.org/10.3348/jksr.2016.74.2.142

Abstract

Influenza-associated encephalitis (IAE) is a complication of a common disease that is rare even during an epidemic. Awareness of magnetic resonance imaging features of IAE is important in treatment planning and prognosis estimation. Several reports have described necrotizing encephalopathy in children with influenza. However, few reports have described multifocal hemorrhages in both cerebral hemispheres in adults with concomitant infection with influenza A and B. Here, we describe a case of influenza A- and B-associated encephalitis accompanied by numerous cerebral hemorrhages.

MeSH Terms

Adult
Cerebral Hemorrhage*
Cerebrum
Child
Encephalitis*
Hemorrhage
Humans
Influenza, Human
Magnetic Resonance Imaging
Prognosis

Figure

• 

  Fig. 1 Hemorrhagic influenza-associated encephalitis in a 19-year-old woman. Magnetic resonance diffusion-weighted images taken on day 8 of illness show restricted diffusion (A) at both thalami (arrows), diffuse leptomeningeal (B) and pachymeningeal (C) enhancement (arrows), and a few hemorrhagic lesions (D) along the subcortical frontal white matter (arrows) showing T1 iso-signal intensity (E) and T2 high-signal intensity (F).

• 

  Fig. 2 Follow-up magnetic resonance imaging (2 weeks later) demonstrates numerous dark low-signal-intensity foci on gradient-echo (A, B) and susceptibility-weighted images (C, D) in subcortical white matter in both cerebral hemispheres; micro- and macrobleeds, normalized bilateral thalamic diffusion restriction (arrows) (E), and small T1 (not shown)/T2 high-signal-intensity lesions (F) in the left frontal lobe; and late subacute hemorrhage (arrow).

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