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Diaschisis in Chronic Viral Encephalitis With Koshevnikov Syndrome
Author(s) -
Thajeb Peterus,
Huang KouMou,
Shih ChiChing
Publication year - 1999
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon199992122
Subject(s) - medicine , magnetic resonance imaging , brain biopsy , lesion , diaschisis , temporal lobe , atrophy , hemiparesis , hyperintensity , encephalitis , cerebellar hemisphere , viral encephalitis , pathology , radiology , cerebellum , epilepsy , virus , virology , psychiatry
The authors report a 61‐year‐old man with chronic viral encephalitis and Koshevnikov syndrome occurring 42 months after initial symptom of right hemiparesis. Serial computed tomography of the brain showed changes in the attenuation of the left temporal lobe lesion over time. Magnetic resonance images of the brain showed enlargement of left temporoparietooccipital lobes with cortical gyral enhancement on T1‐weighted images following intravenous administration of gadolinium‐DTPA. 99m Tc‐HMPAO single‐photon emission computerized tomography showed increased radioactivity and hyperperfusion in the left temporoparietal region with paradoxically decreased local tissue perfusion at the contralateral right hemisphere. Follow‐up madnetic resonance images of the brain 4 years later showed atrophy of bilateral cerebral hemispheres. We postulate that a “transcallosal diaschisis” with subsequent degeneration is a possible mechanism. A brain biopsy from the left temporal lobe lesion showed pictures compatible with viral encephalitis probably herpes simplex encephalitis.