Asymptomatic Hematoma in Herpes Simplex Encephalitis

Soo Jin Song; Boo Suk Na; Jong Min Song; Ho Geol Woo; Dokyung Lee; Tae-Beom Ahn

doi:10.14253/KJCN.2015.17.2.82

Journal List > Korean J Clin Neurophysiol > v.17(2) > 1084166

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Song, Na, Song, Woo, Lee, and Ahn: Asymptomatic Hematoma in Herpes Simplex Encephalitis

Original Article

Korean J Community Nutr 2015;17(2):82-85.

Published online: 18 December 2015

DOI: https://doi.org/10.14253/KJCN.2015.17.2.82

Asymptomatic Hematoma in Herpes Simplex Encephalitis

Soo Jin Song, Boo Suk Na, Jong Min Song, Ho Geol Woo, Dokyung Lee, Tae-Beom Ahn

Department of Neurology, College of Medicine, Kyung Hee University, Seoul, Korea

Address for correspondence; Tae-Beom Ahn Department of Neurology, Kyung Hee University Hospital, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: +82-2-958-8448 Fax: +82-2-958-8490 E-mail: ricash@hanmail.net

Received 21 October 2014 Revised 6 October 2015 Accepted 13 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 59-year old man was admitted for drowsiness and stiff neck. CSF examination showed lymphocytic pleocytosis and PCR for herpes simplex virus (HSV)-1 was positive in CSF. Brain MRI revealed enhanced lesions in left temporal lobe. His symptom improved with acyclovir. Follow-up studies showed red blood cells in CSF and a hematoma in the left temporal lobe. There was no additional symptom related to the hematoma. He was discharged after conservative care. Although rare, hematoma can develop in HSV-1 meningoencephalitis. (Korean J Clin Neurophysiol 2015;17:82-85)

Keywords: Herpes simplex virus, Meningoencephalitis, Acyclovir, Hematoma

REFERENCES

1.Raschilas F., Wolff M., Delatour F., Chaffaut C., De Broucker T., Chevret S, et al. Outcome of and prognostic factors for herpes simplex encephalitis in adult patients: results of a multicenter study. Clin Infect Dis. 2002. 35:254–260.

2.Rodriguez-Sainz A., Escalza-Cortina I., Guio-Carrion L., Matute-Nieves A., Gomez-Beldarrain M., Carbayo-Lozano G, et al. Intracerebral hematoma complicating herpes simplex encephalitis. Clin Neurol Neurosurg. 2013. 115:2041–2045.

3.Jeong H., Ji K., Chung E., Bae J., Kim E., Kim S. Herpes meningoencephalitis complicated by cerebral hematomas during acyclovir therapy. Korean J Stroke. 2011. 13:144–146.

4.Kang B., Ahn J., Kwon S. Bilateral medial temporal hematomas in HSV-1 encephalitis. J Korean Neurol Assoc. 2008. 26:136–138.

5.Ropper AH., Samuels MA., Klein JP. Adams and Victor's principles of neurology. 9th ed.New York: McGraw Hill;2009. p. 720.

Fig. 1.

Brain magnetic resonance imaging (MRI). Fluid attenuated inversion recovery MRI shows high signal intensity in the left medial temporal lobe area, which is enhanced by gadolinium on T1 weighted imaging (A, B). Gradient echo imaging shows no hemorrhage, and magnetic resonance angiography is normal (C, D).

Fig. 2.

Brain computed tomography (CT). CT shows a large hematoma in the left medial temporal lobe (A), which shrinks in the follow-up study (B).

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