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Dengue encephalitis with predominant cerebellar involvement: Report of eight cases with MR and CT imaging features

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Abstract

Objectives

CNS dengue infection is a rare condition and the pattern of brain involvement has not been well described. We report the MR imaging (MRI) features in eight cases of dengue encephalitis.

Materials and methods

We retrospectively searched cases of dengue encephalitis in which imaging was performed. Eight cases (three men, five women; age range: 8–42 years) diagnosed with dengue encephalitis were included in the study. MR studies were performed on 3-T and 1.5-T MR clinical systems. Two neuroradiologists retrospectively reviewed the MR images and analysed the type of lesions, as well as their distribution and imaging features.

Results

All eight cases exhibited MRI abnormalities and the cerebellum was involved in all cases. In addition, MRI signal changes were also noted in the brainstem, thalamus, basal ganglia, internal capsule, insula, mesial temporal lobe, and cortical and cerebral white matter. Areas of susceptibility, diffusion restriction, and patchy post-contrast enhancement were the salient imaging features in our cohort of cases.

Conclusion

A pattern of symmetrical cerebellar involvement and presence of microbleeds/haemorrhage may serve as a useful imaging marker and may help in the diagnosis of dengue encephalitis.

Key Points

• MR images of eight cases diagnosed with dengue encephalitis were retrospectively reviewed.

• Symmetrical cerebellar involvement may serve as an imaging marker on MRI.

• Presence of microbleeds/haemorrhage and diffusion restriction are other salient features.

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Abbreviations

FLAIR:

Fluid-attenuated inversion recovery

DWI:

Diffusion-weighted MR imaging

WM:

White matter

SWI:

Susceptibility-weighted MR imaging

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Acknowledgments

The scientific guarantor of this publication is Dr Jitender Saini. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required as this was a retrospective study of MR images. Written informed consent was not required for this study as this was a retrospective study of MR images. Images of one of the subjects have been published in an article before. Methodology: retrospective, observational, multicenter study.

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Authors and Affiliations

  1. Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029, Karnataka, India

    Vinay Hegde, Maya Bhat, Chandrajit Prasad, A. K. Gupta & Jitender Saini

  2. Department of Radiology, Sri Sathya Sai Institute of Medical Science, Bangalore, India

    Zarina Aziz

  3. Department of Neuroradiology, Apollo Hospital, Jayanagar, Bangalore, India

    Sharath Kumar

  4. Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India

    M. Netravathi

Authors
  1. Vinay Hegde
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  2. Zarina Aziz
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  3. Sharath Kumar
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  4. Maya Bhat
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  5. Chandrajit Prasad
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  6. A. K. Gupta
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  7. M. Netravathi
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  8. Jitender Saini
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Correspondence to Jitender Saini.

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Hegde, V., Aziz, Z., Kumar, S. et al. Dengue encephalitis with predominant cerebellar involvement: Report of eight cases with MR and CT imaging features. Eur Radiol 25, 719–725 (2015). https://doi.org/10.1007/s00330-014-3473-6

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  • DOI: https://doi.org/10.1007/s00330-014-3473-6

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