Acute Necrotizing Encephalopathy in a Four-Year-Old Boy

Cheng-Hsien Tsai; Wei-Sheng Lin

doi:10.3390/diagnostics11030568

Acute Necrotizing Encephalopathy in a Four-Year-Old Boy

Diagnostics (Basel). 2021 Mar 22;11(3):568. doi: 10.3390/diagnostics11030568.

Authors

Cheng-Hsien Tsai¹, Wei-Sheng Lin^{2

3}

Affiliations

¹ Department of Pediatrics, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan.
² Department of Pediatrics, Taipei Veterans General Hospital, Taipei 112, Taiwan.
³ Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan.

Abstract

Acute necrotizing encephalopathy is a devastating clinico-radiological syndrome characterized by fulminant neurological deterioration after an antecedent febrile illness, as well as the imaging hallmark of bilateral thalamic involvement. Herein, we describe a 4-year-old boy with typical clinical and neuroimaging features of acute necrotizing encephalopathy. The bithalamic swelling led to a block of cerebrospinal fluid circulation at the foramen of Monro, thereby causing the mild dilatation of lateral ventricles. The periventricular areas could, therefore, have been potentially affected by the acute necrotizing encephalopathy per se and/or transependymal edema secondary to obstructive hydrocephalus. The information from diffusion imaging allows for differentiation between these two pathophysiological processes.

Keywords: acute necrotizing encephalopathy; hydrocephalus; thalamus.