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Case No. 460
2017-10-01~2017-10-31
출제자 : 이경미
Hit : 284
| Period | 2017-10-01~2017-10-31 |
|---|---|
| Diagnosis | Acute disseminated encephalomyelitis (ADEM) |
| Clinical information | 56/F 내월 10일전, 예방적 폐렴구균 및 독감 예방주사 맞은 이후 발생한 headache Image추가설명: no diffusion restriction, no enhancement |
| Discussion | Acute disseminated encephalomyelitis (ADEM) - monophasic acute inflammation and demyelination of white matter typically following a recent (1-2 weeks prior) viral infection or vaccination - Grey matter, especially that of the basal ganglia, is also often involved, albeit to a lesser extent, as is the spinal cord. -CT The lesions are usually indistinct regions of low density within the white matter and may demonstrate ring enhancement. -MRI • T2: high signal, with surrounding edema typically situated in subcortical locations thalami and brainstem can also be involved • T1 C+ (Gd): punctate, ring or arc enhancement (open ring sign) absence of enhancement does not exclude the diagnosis • DWI: peripherally restricted diffusion |
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Correct Answer
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