A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases

A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases

Metronidazole induced encephalopathy (MIE) is a rare condition due to prolonged high dose administration of metronidazole. MIE with corresponding increased perfusion on MRI arterial spin labeling (ASL) of the involved regions of the brain appears not to have been reported in the literature to date....

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Main Authors: Vivek Yedavalli, MD, MS, Bryan Lanzman, MD
Format: Article
Language:English
Published: Elsevier 2020-01-01
Series:Radiology Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S1930043319303395
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spelling doaj-03284af6c15747a8988f955e4d1a8ea62020-11-24T21:41:24ZengElsevierRadiology Case Reports1930-04332020-01-011517781A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion casesVivek Yedavalli, MD, MS0Bryan Lanzman, MD1Stanford University, Department of Radiology, Division of Neuroradiology and Neurointervention, 300 Pasteur Drive, Room S047, Palo Alto, CA 94305, USA; Correspondence author.Stanford University, Department of Radiology, Division of Neuroradiology and Neurointervention, 300 Pasteur Drive, Room S092, MC 5105, Palo Alto, CA 94305, USAMetronidazole induced encephalopathy (MIE) is a rare condition due to prolonged high dose administration of metronidazole. MIE with corresponding increased perfusion on MRI arterial spin labeling (ASL) of the involved regions of the brain appears not to have been reported in the literature to date. We present two such cases, a 59-year-old male with recurrent C difficile colitis with classic MR imaging characteristics of MIE, and a companion case of a 65-year-old female with gangrenous cholecystitis also presumed to have MIE. Despite aggressive medical management, both patients expired. Our cases demonstrate a correlation with ASL hyperperfusion to affected brain regions thought to be due to edema or inflammation. Perfusion imaging may play a role in diagnosis of MIE. Keywords: Metronidazole, Encephalopathy, Arterial spin labelinghttp://www.sciencedirect.com/science/article/pii/S1930043319303395
collection DOAJ
language English
format Article
sources DOAJ
author Vivek Yedavalli, MD, MS
Bryan Lanzman, MD
spellingShingle Vivek Yedavalli, MD, MS
Bryan Lanzman, MD
A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
Radiology Case Reports
author_facet Vivek Yedavalli, MD, MS
Bryan Lanzman, MD
author_sort Vivek Yedavalli, MD, MS
title A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
title_short A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
title_full A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
title_fullStr A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
title_full_unstemmed A potential new role for ASL perfusion imaging: Diagnosis of metronidazole induced encephalopathy – Two companion cases
title_sort potential new role for asl perfusion imaging: diagnosis of metronidazole induced encephalopathy – two companion cases
publisher Elsevier
series Radiology Case Reports
issn 1930-0433
publishDate 2020-01-01
description Metronidazole induced encephalopathy (MIE) is a rare condition due to prolonged high dose administration of metronidazole. MIE with corresponding increased perfusion on MRI arterial spin labeling (ASL) of the involved regions of the brain appears not to have been reported in the literature to date. We present two such cases, a 59-year-old male with recurrent C difficile colitis with classic MR imaging characteristics of MIE, and a companion case of a 65-year-old female with gangrenous cholecystitis also presumed to have MIE. Despite aggressive medical management, both patients expired. Our cases demonstrate a correlation with ASL hyperperfusion to affected brain regions thought to be due to edema or inflammation. Perfusion imaging may play a role in diagnosis of MIE. Keywords: Metronidazole, Encephalopathy, Arterial spin labeling
url http://www.sciencedirect.com/science/article/pii/S1930043319303395
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