tetano
Editor, Senior Moderator
J Korean Soc Radiol
. 2024 May;85(3):682-690.
doi: 10.3348/jksr.2023.0023. Epub 2024 May 14.
MRI Findings of COVID-19 Associated Acute Necrotizing Encephalopathy in Two Pediatric Patients: Case Report and Literature Review
Yoon Yeong Choi, Ha Young Lee, Myung Kwan Lim, Young Hye Kang
in English, Korean
Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.
Keywords: Acute Necrotizing Encephalopathy; Brain Magnetic Resonance Imaging; COVID-19; Coronavirus Disease 2019; Pediatric.
. 2024 May;85(3):682-690.
doi: 10.3348/jksr.2023.0023. Epub 2024 May 14.
MRI Findings of COVID-19 Associated Acute Necrotizing Encephalopathy in Two Pediatric Patients: Case Report and Literature Review
Yoon Yeong Choi, Ha Young Lee, Myung Kwan Lim, Young Hye Kang
- PMID: 38873375
- PMCID: PMC11166599
- DOI: 10.3348/jksr.2023.0023
in English, Korean
Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.
Keywords: Acute Necrotizing Encephalopathy; Brain Magnetic Resonance Imaging; COVID-19; Coronavirus Disease 2019; Pediatric.