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

Abstract

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.