MRI Findings of COVID-19 Associated Acute Necrotizing Encephalopathy in Two Pediatric Patients: Case Report and Literature Review
- Author:
Yoon Yeong CHOI
1
;
Ha Young LEE
;
Myung Kwan LIM
;
Young Hye KANG
Author Information
- Publication Type:Case Report
- From: Journal of the Korean Society of Radiology 2024;85(3):682-690
- CountryRepublic of Korea
- Language:English
- Abstract: Acute necrotizing encephalopathy (ANE) is a rare immune-mediated complication of a viral infection commonly involving the bilateral thalamus and has been reported mainly in children. Here, we describe the MRI findings of coronavirus disease 2019 (COVID-19)-associated ANE in two pediatric patients, including a 7-year-old girl with fever and mental change, and a 6-year-old girl with fever and generalized seizures. Brain MRI revealed symmetrical T2 fluid attenuated inversion recovery high-signal intensity lesions in the bilateral thalamus with central hemorrhage. In one patient, the thalamic lesions showed a trilaminar pattern on the apparent diffusion coefficient map. This report emphasizes the importance of creating awareness regarding these findings in patients with COVID-19, particularly in children with severe neurological symptoms. Furthermore, it provides a literature review of several documented cases of COVID-19 presenting with bilateral thalamic hemorrhagic necrosis, suggesting a diagnosis of ANE.
