A31yearoldmanfo [复制链接]

A31-year-oldmanfoundunresponsive.

A

B

C

Whatisyourdiagnosis?

TheanswerisHerpesSimplexEncephalitis

Herpessimplexvirus(HSV)encephalitisisgenerallythoughttooccurasaformofreactivationofHSV-1virusintheganglionofthetrigeminalnerve,whichsubsequentlytravelsalonganerveaxontothebrain.

T2-weightedFLAIRMRI(figuresAandB)revealshyperintensitycorrespondingtoedematouschangesinthetemporallobes,inferiorfrontallobes,andinsula,withapredilectionforthemedialtemporallobes.

TheT2hyperintensityreflectscytotoxicedemaasshownwithrestricteddiffusiononDWI(figureC).

Typically,thebasalgangliaarespared.

中文版：

男性，31岁，发现无反应

诊断：单纯疱疹病*性脑炎

单纯疱疹病*性脑炎通常认为是因三叉神经节处的单纯疱疹病*1型重新活化，并通过神经轴索播散至脑内而引起。

病变于MRIT2FLAIR像（A,B图）表现为颞叶、额叶底部以及岛叶异常高信号，尤其好发于颞叶内侧，提示为水肿改变。

T2WI表现为高信号，DWI表现为弥散受限，表明病变区域为细胞*性水肿（C图）。

双侧基底节区通常不受累及。