PNR Head 20

History

11 yo F with headache, blurry vision, and dizziness

Major Findings

Right thalamus and brainstem hypodensity, which could be due to edema from acute encephalomyelitis, ADEM, MS, vasculitis, stroke, glioma.
Concurrent MRI shows corresponding areas of hyperintensity suggestive of demyelinating disease like ADEM or MS; these areas resolved on subsequent MRI, consistent with ADEM

Teaching Points

Remember to use multiplanar reformats and narrow windowing to look for asymmetric hypodensities.

ADEM (acute disseminated encephalomyelitis) is a self-limited, single episode of demyelination which occurs in your individuals, often after a viral infection. Unlike MS, ADEM typically resolves after one episode and rarely recurs.

Accession: CL0635

Study description: CT HEAD W/O CONTRAST