{"id":19138,"date":"2020-12-27T16:21:26","date_gmt":"2020-12-27T22:21:26","guid":{"rendered":"http:\/\/www.ajnrblog.org\/?p=19138"},"modified":"2020-12-27T16:21:32","modified_gmt":"2020-12-27T22:21:32","slug":"clinical-and-radiologic-findings-of-acute-necrotizing-encephalopathy-in-young-adults","status":"publish","type":"post","link":"https:\/\/www.ajnrblog.org\/2020\/12\/27\/clinical-and-radiologic-findings-of-acute-necrotizing-encephalopathy-in-young-adults\/","title":{"rendered":"Clinical and Radiologic Findings of Acute Necrotizing Encephalopathy in Young Adults"},"content":{"rendered":"<div class=\"editor-comment\">\n<h1>Fellows&#8217; Journal Club<\/h1>\n<p>The authors describe 10 patients (16 years of age or older) with acute necrotizing encephalopathy. In their study, bilateral thalamic involvement with the trilaminar pattern of diffusion restriction on MR imaging was the predominant finding seen in all of the patients reviewed. Ancillary findings of cerebral white matter, brain stem, and cerebellum involvement with sparing of the basal ganglia were also seen.<\/p>\n<p class=\"signature\"><img decoding=\"async\" src=\"http:\/\/www.ajnrblog.org\/wp-content\/uploads\/ross-signature.png\" alt=\"\" \/><\/p>\n<p><!--more--><\/p>\n<\/div>\n<h2 class=\"signature\">Abstract<\/h2>\n<div id=\"sec-1\" class=\"subsection\">\n<figure id=\"attachment_19140\" aria-describedby=\"caption-attachment-19140\" style=\"width: 300px\" class=\"wp-caption alignright\"><a href=\"http:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-19140 size-medium\" src=\"http:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_-300x111.jpg\" alt=\"Figure from Vanjare et al\" width=\"300\" height=\"111\" srcset=\"https:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_-300x111.jpg 300w, https:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_-150x55.jpg 150w, https:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_-630x232.jpg 630w, https:\/\/www.ajnrblog.org\/wp-content\/uploads\/F1.large6_.jpg 1800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-19140\" class=\"wp-caption-text\"><em>A\u2013E<\/em>, T2-weighted axial sections demonstrating the involvement of cortical gray matter, white matter, thalami, brain stem, and cerebellar hemispheres. <em>F\u2013I<\/em>, DWI axial sections demonstrating diffusion restriction in thalami, cerebral, and cerebellar white matter. Trilaminar pattern on ADC (<em>G<\/em>) as a low signal ring (<em>arrows<\/em>) with central and peripheral hyperintensity. <em>J<\/em> and <em>K<\/em>, SWI demonstrating microhemorrhages in thalami and brain stem.<\/figcaption><\/figure>\n<div id=\"sec-4\" class=\"subsection\">\n<p>Acute necrotizing encephalopathy after an acute febrile illness, although initially described exclusively in the pediatric age group, has been recently shown to have an adult onset as well. In this study, we describe 10 patients (16\u2009years of age or older) with acute necrotizing encephalopathy. In our study, bilateral thalamic involvement with the trilaminar pattern of diffusion restriction on MR imaging was the predominant finding seen in all of the patients reviewed. Ancillary findings of cerebral white matter, brain stem, and cerebellum involvement with sparing of the basal ganglia were also noted. A poorer outcome was observed in patients with a higher degree of thalamic involvement. The cause of an underlying infection was identified in 4 patients (dengue in 3 and influenza in 1). Overall, a sizeable portion of young adults with acute necrotizing encephalopathy have shown a poorer outcome, with dengue being an important underlying trigger in an endemic region.<\/p>\n<p><strong data-rich-text-format-boundary=\"true\">Read this article: <a href=\"https:\/\/bit.ly\/38D7qm9\">https:\/\/bit.ly\/38D7qm9<\/a><\/strong><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Fellows&#8217; Journal Club The authors describe 10 patients (16 years of age or older) with acute necrotizing encephalopathy. In their study, bilateral thalamic involvement with the trilaminar pattern of diffusion restriction on MR imaging was the predominant finding seen in<\/p>\n","protected":false},"author":21,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,13],"tags":[1602],"class_list":["post-19138","post","type-post","status-publish","format-standard","hentry","category-brain","category-fellows-journal-club","tag-acute-necrotizing-encephalopathy"],"_links":{"self":[{"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/posts\/19138","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/users\/21"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/comments?post=19138"}],"version-history":[{"count":2,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/posts\/19138\/revisions"}],"predecessor-version":[{"id":19152,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/posts\/19138\/revisions\/19152"}],"wp:attachment":[{"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/media?parent=19138"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/categories?post=19138"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ajnrblog.org\/wp-json\/wp\/v2\/tags?post=19138"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}