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Clinical Neuroradiology
Published in: Clinical Neuroradiology 2/2020

01-06-2020 | Magnetic Resonance Imaging | Original Article

Varying Patterns of CNS Imaging in Influenza A Encephalopathy in Childhood

Authors: Mete Dadak, Refik Pul, Heinrich Lanfermann, Hans Hartmann, Ute Hehr, Frank Donnerstag, Dirk Michels, Anita Blanka Tryc

Published in: Clinical Neuroradiology | Issue 2/2020

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Abstract

Purpose

The brain imaging findings in children with neurological complications associated with influenza A infections are presented and analyzed and pathological imaging changes including atypical intracerebral hemorrhages in these patients are discussed.

Methods

Neuroimaging findings in six children with influenza encephalopathy following influenza A infection between 2012–2017 were retrospectively investigated. Of these five underwent magnetic resonance imaging (MRI) and one computed tomography (CT). Gene analysis was performed in two cases with acute necrotizing encephalitis of childhood (ANEC).

Results

The MRI findings of one child were concordant with mild encephalopathy with a reversible splenial lesion (MERS); this patient recovered but remained aphasic. In two cases MRI showed typical bilateral thalamic lesions as a feature of ANEC; genetic testing facilitated the diagnosis in one case. One of the patients died, the other showed little improvement. The remaining three patients had multiple diffuse cerebral hemorrhages predominantly affecting the supratentorial white matter after influenza A infection complicated by pneumonia, rhabdomyolysis and sepsis requiring extracorporeal membrane oxygenation (ECMO).

Conclusion

Neurological complications in children associated with influenza A infection may include MERS and ANEC. Additionally, atypical disseminated intracerebral hemorrhages as a complication of influenza A infection is reported.
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Metadata
Title
Varying Patterns of CNS Imaging in Influenza A Encephalopathy in Childhood
Authors
Mete Dadak
Refik Pul
Heinrich Lanfermann
Hans Hartmann
Ute Hehr
Frank Donnerstag
Dirk Michels
Anita Blanka Tryc
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 2/2020
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-018-0756-3

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