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Case No. 358
2014-12-01~2014-12-31
출제자 : 최진욱
Hit : 392
| Period | 2014-12-01~2014-12-31 |
|---|---|
| Diagnosis | Acute hemorrhagic leukoencephalitis |
| Clinical information | M/19 C.C : Rapidly progressive impairment of cognitive and executive function |
| Discussion | Acute hemorrhagic leukoencephalitis Rare acute CNS demyelinating disease – Most severe form of ADEM – Also known as Hurst disease – Typically affecting children and young adults Clinical presentation – Long tract signs – Impairment of consciousness – Death within days Pathophysiology – Following respiratory infection – Probably autoimmune nature Cross reactivity between myelin antigen and infectious antigen – Perivascular demyelination and hemorrhage With neutrophilic and macrophage inflammatory infiltrates MRI finding – Diffuse involvement of supratentorial white matter Sparing cortex and U-fibers May involve basal ganglia or thalamus – With associated punctuate hemorrhagic foci – Diffusion restriction and enhancement in acute phase – Decreased NAA and increased choline on MRS Reference, Acute hemorrhagic encephalomyelitis in childhood: Case report and literature review, Journal of Pediatric Neuroscience, 2011;6:48-51 |
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Correct AnswerSemi-Correct Answer |