Naslov
West Nile encephalitis - radiologic findings with clinical correlation

Autori
Višković, Klaudija

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Program and Abstract Book: Virtual Symposium with International Participation:(RE-)EMERGING ARBOVIRUSES IN THE SHADOW OF COVID-19 PANDEMIC / - Zagreb, 2021, 33-33

Skup
(Re-)emergentni arbovirusi u sjeni pandemije COVID-19 (Re-)Emerging Arboviruses in the Shadow of COVID-19 pandemic

Mjesto i datum
Zagreb, Hrvatska, 10.06.2021. - 11.06.2021

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
West Nile Virus ; clinical-radiologic correlation ; cauda equina arachnoiditis

Sažetak
West Nile virus neuroinvasive disease (WNV NID) is the most severe clinical presentation of WNV infection. WNV NID usually presents as meningoencephalitis and myelitis, or as a combination of both. It has become an emerging infection with rapid increases in the incidence and geographic range. The purpose of this presentation is to report and describe the range of magnetic resonance imaging (MRI) findings of the brain and spine in patients with documented WNV infection treated at the University Hospital for Infectious Diseases (UHID) in Zagreb, Croatia and to increase radiologic and clinical diagnosis of the condition. We investigated a correlation between imaging findings and clinical presentation of patients hospitalized in the period between August and October 2018. MRI findings are reported as abnormal in about one third of cases and generally are nonspecific. In our patients, MRI images in T2 and/or Fluid Attenuation Inversion Recovery (FLAIR) sequences revealed hyperintensity signal lesions in deep brain structures, including the thalami, basal ganglia and cerebral peduncle. These lesions usually have no associated mass effect or abnormal contrast enhancement. One patient had confluent white matter lesion in periventricular region. We also report a patient with cauda equina arachnoiditis which is a rare manifestation of WNV NID. Generally, the virus can affect any part of the neural axis, but there is a predilection for brainstem, cerebellum, and anterior horn cells of the spinal cord. MRI may also show the thickening and enhancement of leptomeninges. Diffusion Weighted Image (DWI) may detect an inflammation prior to signal intensity changes detected using T2/FLAIR. Differential diagnosis comprises demyelinating process in the brain including multiple sclerosis (MS), acute disseminated encephalomyelitis, chronic microvascular white matter ischemic disease or other viral encephalitis. Differential diagnosis of findings in the spinal cord and cauda equina includes transverse myelitis, viral myelitis and leptomeningeal metastatic disease.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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