Abstract
BackgroundHeat stress results in multiorgan failure and CNS injury. There a few case reports in the literature on the neurological consequences of heat stress.Case presentationWe describe a patient with heat stress presenting with encephalopathy and bilateral cerebral, cerebellar, and thalamic lesions and intraventricular hemorrhage on MRI.ConclusionHeat stress should be in the differential diagnosis of patients presenting with encephalopathy and elevated serum inflammatory markers especially if the history suggests a preceding episode of hyperthermia.
Highlights
Heat stress results in multiorgan failure and CNS injury
We report a patient with heat stress presenting with encephalopathy and bilateral cerebral, cerebellar, and thalamic lesions and intraventricular hemorrhage on MRI
Heat stress can cause multiple serious systemic complications ranging from rhabdomyolysis to DIC syndrome to multi-organ failure
Summary
Heat stroke is a medical emergency resulting from a body temperature of greater than 40°C (104°F) usually resulting in alteration of consciousness [1,2] and associated with a 10%-50% mortality rate [3]. The patient had been cattle ranching four days prior to his initial hospital presentation. On the third day of cattle ranching, the patients’ mental status deteriorated as he became increasingly lethargic He was taken to an outside hospital and was intubated for airway protection. Diffusion weighted magnetic resonance imaging showed multiple punctate foci of restricted diffusion involving the frontoparietal cerebral cortex and cerebellum bilaterally as well as two larger foci in the dorsomedial and ventrolateral thalami bilaterally (Figure 1). These abnormal lesions showed decreased ADC and heterogeneous postcontrast enhancement (Figure 2). After two weeks of inpatient therapy, the patient had persistent cognitive deficits including poor short term memory
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