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Multicystic encephalomalacia complicating neonatal herpes simplex encephalitis : Clinical findings and neonatal ultrasound appearance.
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- Tatsuno Masaru
- Department of pediatrics, Showa University of Medicine
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- Itoh Sadao
- Department of pediatrics, Showa University of Medicine
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- Ohno Hiromi
- Department of pediatrics, Showa University of Medicine
Bibliographic Information
- Other Title
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- 新生児ヘルペス脳炎による多のう胞性脳軟化症の１例 臨床および頭部断層エコー所見
- 臨床および頭部断層エコー所見
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Description
We report a case of infantile multicystic encephalomalacia, together with the diagnostic cranial ultrasound findings.<BR>The girl was born by spontaneous delivery after uneventful term gestation. Birth weight was 3, 000g. She was well until age 15 days, when she developed fever and multifocal clonic convulsions. She was admitted to our hospital at 16 days of age. Initial physical examination showed nuchal rigidity, fever, diffuse hyperreflexia and intermittent seizures. The fontanelle was not bulging and the head circumference was 33.5 cm. Examination of the CSF revealed an erythrocytic and monocytic pleocytosis, elevated protein and decreased glucose. Complement fixation titer to herpes simplex was<1: 1 in CSF. One month later it rose to 1: 4. No virus was isolated from CSF, throat, urine, or stool. The infant survived her acute illness, but was left with severe neulorogic sequelae manifested as microcephaly, spastic quadriparesis and cortical blindness.<BR>A CT scan on the 8th day of illness demonstrated the edema of the white and cortex. Repeated CT scan at 28 days revealed scattered areas of decreased attenuation in the cortex and subcortical white matter. Cranial ultrasound examination was performed on the 9, 11, 12, 13, 15, 22, 29, 31, 44, 58, 66 and 132 th day of illness. On the 29th, these revealed generalized ventricular enlargement and mutiple cysts.<BR>On CT scan, multiple cysts would be difficult to detect. But ultrasound examination clearly and easily demonstrated the multicystic intracranial lesions. We consider neonatal cranial ultrasound is the most useful for the diagnosis of this disease.
Journal
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- NO TO HATATSU
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NO TO HATATSU 16 (4), 322-327, 1984
THE JAPANESE SOCIETY OF CHILD NEUROLOGY