RT Journal Article
SR Electronic
T1 Serial Proton MR Spectroscopy and Diffusion Imaging Findings in HIV-Related Herpes Simplex Encephalitis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2015
OP 2019
VO 24
IS 10
A1 Sämann, Philipp G.
A1 Schlegel, Jürgen
A1 Müller, Georg
A1 Prantl, Franz
A1 Emminger, Christoph
A1 Auer, Dorothee P.
YR 2003
UL http://www.ajnr.org/content/24/10/2015.abstract
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.