PT  - JOURNAL ARTICLE
AU  - Philipp G. Sämann
AU  - Jürgen Schlegel
AU  - Georg Müller
AU  - Franz Prantl
AU  - Christoph Emminger
AU  - Dorothee P. Auer
TI  - Serial Proton MR Spectroscopy and Diffusion Imaging Findings in HIV-Related Herpes Simplex Encephalitis
DP  - 2003 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2015--2019
VI  - 24
IP  - 10
4099  - http://www.ajnr.org/content/24/10/2015.short
4100  - http://www.ajnr.org/content/24/10/2015.full
SO  - Am. J. Neuroradiol.2003 Nov 01; 24
AB  - Summary: We report the case of pathologically proved atypical herpes simplex encephalitis (HSE) in a 40-year-old male patient with AIDS who was followed up by MR imaging, which included diffusion-weighted imaging and proton MR spectroscopy (1H-MRS). MR revealed sparing of hippocampi and limbic cortices, necrosis of both cingulate gyri, and cerebellar involvement. Increased diffusivity and severe metabolic alterations were compatible with biopsy findings of necrotizing inflammation. Clinical recovery corresponded with partial metabolite and diffusion normalization and a myo-inositol increase that indicated evolving gliosis formation further corroborated by immunohistochemistry results. 1H-MRS and diffusion-weighted imaging may both support the diagnosis of HSE in patients with AIDS and help in the follow-up of necrotizing inflammation.