Acute necrotizing encephalopathy of childhood (ANEC)- Trilaminar sign on MRI

Mounisha Kethineni,Venkatesh Manchikanti,Sundeep Nvk

doi:10.15761/cmi.1000204

Abstract

Acute necrotizing encephalopathy of childhood (ANEC)- Trilaminar sign on MRI

Highlights

Acute necrotising encephalopathy of childhood (ANEC) affects infants and children and can present with respiratory or gastrointestinal infection and high fever accompanying with rapid alteration of consciousness and seizures
We present a case of a previously healthy 2 year old child which was referred to us with fever and altered sensorium since 1 day
The hallmark of neuroradiologic manifestations of ANE is multifocal, symmetric brain lesions involving both gray matter and white matter which are demonstrated by computed tomography (CT) or magnetic resonance imaging (MRI), i.e consistent with histopathologic findings via autopsy

Summary

Introduction

Acute necrotising encephalopathy of childhood (ANEC) affects infants and children and can present with respiratory or gastrointestinal infection and high fever accompanying with rapid alteration of consciousness and seizures. ANEC is characterized by multiple, symmetrical lesions in the thalami, putamina, cerebral and cerebellar white matter, and brainstem tegmentum [1]. We present a case of a previously healthy 2 year old child which was referred to us with fever and altered sensorium since 1 day. MRI was done by using Philips achieva 1.5 T machine revealed multiple symmetrical T2 hyper intense areas(Figure 1) noted involving bilateral thalami capsular region, mid brain and pons showing areas of diffusion restriction with reduced ADC values and few foci of blooming on GRE sequence(Figure 2) (hemorrhagic foci).

Discussion

Findings

Conclusion