Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Practice Cases
Worklist 1
11 topics, 59 min.
Practice Cases
Worklist 2
11 topics, 42 min.
Practice Cases
Worklist 3
11 topics, 45 min.
Practice Cases
Worklist 4
11 topics, 50 min.
Practice Cases
Worklist 5
11 topics, 33 min.
Practice Cases
Worklist 6
11 topics, 48 min.
Practice Cases
Worklist 7
11 topics, 51 min.
Practice Cases
Worklist 8
11 topics, 55 min.
Practice Cases
Worklist 9
11 topics, 51 min.
Practice Cases
Worklist 10
11 topics, 35 min.
Wk 7, Case 1 - Review
HIDEInteractive Transcript
Report
Patient History
Not following commands, fever, post-ictal
Findings
INDICATION: not following commands, fever, post-ictal
COMPARISON: No prior MRI brain available for comparison. CT head performed on 11/3/2021.
TECHNIQUE: Multiplanar multisequence pre and post contrast MR sequences through the head/brain.
CONTRAST: 8.5mL Gadavist IV.
BRAIN FINDINGS:
Enhancement of the mesial left temporal lobe with corresponding T2 / FLAIR hyperintensity and restricted diffusion. In addition, there is T2 FLAIR hyperintensity of the cingulum on the left side, best seen on series 6 image 17. The posterior gyrus rectus on the left side is also affected. This also corresponds to area susceptibility representing hemorrhagic transformation in the mesial temporal lobe which was also seen on the prior CT as demonstrated by corresponding area of hyperdensity.
Prominent ventricles and sulci are seen representing cerebral volume loss, unchanged from the prior CT. Overlying the high left frontal convexities there is high signal inteabsence of suppression.
There are no other areas of restricted diffusion. No other areas of intraparenchymal hemorrhage.
Status post bilateral lens extraction. Mucosal thickening of the medial paranasal sinuses. No effusion seen in the mastoid air cells. Calvarium is intact.
Impressions
Enhancement of the left mesial temporal lobe and left cingulum with adjacent T2 FLAIR hyperintensity compatible with HSV 1 encephalitis. Absence of suppression of the parietal convexities compatible with meningitic component. Hemorrhagic transformation is present, unchanged compared to the prior CT.
Case Discussion
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Joshua P Nickerson, MD
Associate Professor of Neuroradiology
Oregon Health & Science University
Francis Deng, MD
Assistant Professor of Radiology and Radiological Science
Johns Hopkins University School of Medicine
Tags
Neuroradiology
MRI
Infectious
Brain
© 2024 Medality. All Rights Reserved.