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    Home > Active Ingredient News > Study of Nervous System > A 10-year-old boy with developmental delay + mental abnormality, this case is said to be undiagnosed by 60% of doctors!

    A 10-year-old boy with developmental delay + mental abnormality, this case is said to be undiagnosed by 60% of doctors!

    • Last Update: 2022-01-04
    • Source: Internet
    • Author: User
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    *Not easy to read for medical professionals.
    The patient, male, 10 years old, presented with developmental delay and mental disorders

    Look at the image below, what do you consider the patient’s diagnosis? ---Answer dividing line---Are you sure you want to see the answer? ▌ Image analysis FLAIR images show that the medial cerebellar hemisphere, cerebellar nucleus, cerebellar peduncle, brain stem [medulla oblongata (a) and pons (b)] have abnormal symmetrical signals and no space-occupying effect

    ▌ Imaging diagnosis of Leigh syndrome

     ▌ Differential diagnosis 1.
    Posterior encephalitis is an infection of the brain parenchyma.
    The pathogen can be a virus or a bacteria because the infection spreads directly or spreads through blood

    Bacterial infections are common in immunosuppressed patients, and abscesses are likely to form if treatment is not timely

    Viral encephalitis mostly affects the deep gray matter and white matter of the brain.
    Those that affect the hindbrain (cerebellum, pons, and medulla oblongata) are called posterior encephalitis

    Viral encephalitis is manifested as a high signal on the T2 image, involving the deep gray matter and white matter of the brain, including the cerebellum and brainstem

    Demyelinating lesions Acute disseminated encephalomyelitis (ADEM) is the most common demyelinating lesion in children

    The course of the disease is uniphasic, mostly secondary to proviral infection or vaccination

    MRI showed continuous T2 hyperintensity lesions in the white matter, mostly bilateral, with asymmetrical distribution

    Involvement of the corpus callosum, cerebellar hemispheres, visual pathways, and brainstem are characteristic manifestations

    The lesion around the ventricle is oval and perpendicular to the lateral ventricle, forming a typical "Dawson finger" sign

     ▌ Image points A.
    Posterior encephalitis refers to the infection of the parenchyma of the back of the brain, including the cerebellum, medulla oblongata, and pons; B.
    Demyelinating lesions mostly involve the cerebellum and brainstem, and ADEM is more common in children; C.
    Metabolic disease is a rare neurodegeneration The clinical and imaging manifestations of sexual lesions are similar to those of degenerative lesions

    References: [1]Barkovich AJ, Good WV, Koch TK, et al.
    Mitochondrial disorders: analysis of their clinical and imaging characteristics[J].
    American Journal of Neuroradiology, 1993, 14(5): 1119-1137.
    More “Reading an image every day” can scan the code to view the medical community’s efforts to ensure that its published content is accurate and reliable at the time of review and approval, but it does not know the timeliness of the published content, as well as the accuracy and accuracy of the referenced materials (if any).
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