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Case No. 344
2014-08-01~2014-08-31
출제자 : 차지훈
Hit : 369
| Period | 2014-08-01~2014-08-31 |
|---|---|
| Diagnosis | Japanese encephalitis |
| Clinical information | F/74 drowsy mentality, fever 진단은? |
| Discussion | Imaging findings - Bilateral symmetric T2/FLAIR hyperintensity of thalamus, hippocampus, part of midbrain - No enhancement, no hemorrhage, mildly increased CBV - Some portion of diffusion restriction with vasogenic edema Review - Caused by Japanese encephalitis virus, flaviviridae family Endemic in Southeast Asia, summer and early autumn Vector : Culex tritaeniorhynchus mosquito - Acute fulminant neurological disease Fever, rigor, headache, rapid development of focal neurological signs, and unconsciousness - Diagnosis : IgM antibody (ELISA) detection in serum and CSF - Imaging findings Gray matter > white matter Bilateral T2 thalamic hyperintensity characteristic, unilateral less common Also can involve basal ganglia, substantia nigra, red nucleus, pons, hippocampus, cerebral cortex, cerebellum, subcortical white matter Some lesions may be hemorrhagic, no enhancement |
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