Improved Detection of Heat Stroke-Induced Brain Injury by High B-Value Diffusion-Weighted Imaging

Kobayashi, Kentaro; Tha, Khin Khin; Terae, Satoshi; Iijima, Yuki; Katabami, Kenichi; Minami, Yosuke; Uegaki, Shinji; Gando, Satoshi; Shirato, Hiroki

doi:10.1097/rct.0b013e3182220082

“…The lesions of the cerebellum are mainly concentrated in cerebellar cortex, superior cerebellar peduncle, vermis of cerebellum, corpora dentatum. Besides, the caudate nucleus of basal ganglia are high-incidence areas [6,7,9,[11][12][13][14][15][16][17][18]. However, our case presents symmetrical lesions of both sides of the posterior limb of internal capsule, putamen, external capsule and insula lobe and subcortical white matter, which has not been reported before.…”

Section: Discussionmentioning

confidence: 51%

MRI and MRV features of a patient with Heat Stroke: a case report

Cao

¹

,

Wang

²

,

Gao

³

et al. 2019

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0

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Background Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction including damage to the central nervous system (CNS), which can be life-threatening in severe cases. The brain image lesions of HS patient with CNS damage has been rarely reported before and usually variable in different cases, causing confusing to doctors when encounter these patients in the clinic. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young people and children. The pathogenesis of brain damage caused by HS is complex, CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we report a case of HS with CVT with symmetrical lesions in the bilateral putamen,posterior limb of internal capsule,external capsule, insula lobe, and subcortical white matter inside the brain. Case presentation We introduced a 48-year-old man who suffered from HS in the hot summer. At the time of admission, he showed high body temperature, coma and shock. Later, he had laboratory evidence of rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, acid-base balance disorders, and high D-dimer levels. After several days of anti-shock treatment, his level of consciousness has improved but his vision has declined. The cerebral magnetic resonance imaging (MRI) showed symmetrical lesions of the bilateral posterior limb of internal capsule,putamen,external capsule and insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the formation of deep cerebral venous thrombosis (DCVT). Therefore, the anti-coagulation treatment was given to patient. After timely clinical intervention, the symptom of the patient was gradually improved. Conclusions The case shows that HS can cause CVT. Therefore, we believe that when we need to identify the cerebral MRI findings of HS, early MRV can greatly help the diagnosis of the disease, and can effectively improve the prognosis.

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“…The lesions of the cerebellum are mainly concentrated in the cerebellar cortex, superior cerebellar peduncle, vermis of the cerebellum, and corpora dentatum. In addition, the common lesion site is the caudate nucleus of the basal ganglia [6,7,9,[11][12][13][14][15][16][17][18]. However, our case involved symmetrical lesions in both sides of the posterior limb of the internal capsule, putamen, external capsule, insular lobe, and subcortical white matter, which has not been reported before.…”

Section: Discussionmentioning

confidence: 63%

Magnetic resonance imaging and magnetic resonance venography features in heat stroke: a case report

Cao

¹

,

Wang

²

,

Gao

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction, including damage to the central nervous system (CNS), which can be life-threatening in severe cases. Brain lesions in patients with HS who present with CNS damage have been rarely reported before, and they usually vary in different cases, hence, patients with such lesions may present a clinical challenge in terms of diagnosis and management. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young individuals and children. The pathogenesis of brain damage caused by HS is complex, and CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we have reported a case of a patient with HS having CVT with symmetrical lesions in the bilateral putamen, posterior limb of the internal capsule, external capsule, insular lobe, and subcortical white matter in the brain. Case presentation: We encountered a 48-year-old man who presented with HS in the summer season. During admission, he had a high body temperature and was in coma and shock. Then, he developed rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, and acid–base balance disorders, and his D-dimer level was elevated. After several days of anti-shock treatment, the patient’s level of consciousness improved. However, he experienced a decline in vision. Cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the bilateral posterior limb of the internal capsule, putamen, external capsule, insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the development of CVT. Therefore, anti-coagulation treatment was provided. After timely clinical intervention, the symptoms of the patient gradually improved. Conclusions: This case showed that HS can cause CVT. Therefore, cerebral MRI findings in HS must be assessed; in addition, early MRV can help in the diagnosis of the disease, which can effectively improve prognosis.

show abstract

“…The lesions of the cerebellum are mainly concentrated in cerebellar cortex, superior cerebellar peduncle, vermis of cerebellum, corpora dentatum. Besides, the caudate nucleus of basal ganglia are high-incidence areas [6,7,9,[11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

MRI and MRV features of a patient with Heat Stroke: a case report

Cao

¹

,

Wang

²

,

Gao

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction including damage to the central nervous system (CNS), which can be life-threatening in severe cases. The brain image lesions of HS patient with CNS damage has been rarely reported before and usually variable in different cases, causing confusing to doctors when encounter these patients in the clinic. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young people and children. The pathogenesis of brain damage caused by HS is complex, CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we report a case of HS with CVT with symmetrical lesions in the bilateral putamen,posterior limb of internal capsule,external capsule, insula lobe, and subcortical white matter inside the brain. Case presentation We introduced a 48-year-old man who suffered from HS in the hot summer. At the time of admission, he showed high body temperature, coma and shock. Later, he had laboratory evidence of rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, acid-base balance disorders, and high D-dimer levels. After several days of anti-shock treatment, his level of consciousness has improved but his vision has declined. The cerebral magnetic resonance imaging (MRI) showed symmetrical lesions of the bilateral posterior limb of internal capsule,putamen,external capsule and insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the formation of deep cerebral venous thrombosis (DCVT). Therefore, the anti-coagulation treatment was given to patient. After timely clinical intervention, the symptom of the patient was gradually improved. Conclusions The case shows that HS can cause CVT. Therefore, we believe that when we need to identify the cerebral MRI findings of HS, early MRV can greatly help the diagnosis of the disease, and can effectively improve the prognosis.

show abstract

Improved Detection of Heat Stroke-Induced Brain Injury by High B-Value Diffusion-Weighted Imaging

Cited by 13 publications

References 21 publications

MRI and MRV features of a patient with Heat Stroke: a case report

MRI and MRV features of a patient with Heat Stroke: a case report

Magnetic resonance imaging and magnetic resonance venography features in heat stroke: a case report

MRI and MRV features of a patient with Heat Stroke: a case report

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