TY -的T1 HSV-2视网膜炎和脑炎伪装成巨细胞动脉炎和急性缺血性中风的中脑(p12 - 10.002) JF -神经学乔-神经学做- 10.1212 / WNL。首页0000000000202537六世- 100 - 17补充2 SP - 2415 AU -哈利萨瑟兰盟-克里斯汀Gummerson盟-亚当De Havenon Y1 - 2023/04/25 UR - //www.ez-admanager.com/content/100/17_Supplement_2/24首页15.abstract N2 -目的:描述一个中风模仿的独特案例。背景:非血管引起的急性神经症状临床和放射学模拟缺血性中风。在脑干,这些因素通常局限于肿瘤,脱髓鞘、传染性病因。mesencephalitis HSV-2很少会导致孤立。设计/方法:我们描述一个病人出现头痛、关节痛、和视觉障碍谁最初确诊为巨细胞动脉炎(GCA)但最终发现HSV-2感染。结果:一个75岁的老人与过去病史的心房纤颤(药apixaban)、高血压、高脂血症、类风湿性关节炎(adalimumab)提出了评价步态不稳。四个星期前表示,他开发了双时态头痛没有视觉症状,关节痛。他的风湿病学家检查ESR(40)和命令颞动脉活检。他提出了天apixaban活检前举行(本课程前1周),右眼下视野损失。Fundoscopy显示盘水肿觉得符合前部缺血性视神经病变。 He was treated with pulse-dose steroids out of concern for GCA and underwent bilateral temporal artery biopsy before being discharged home on an oral steroid taper and resumed anticoagulation. CT, CTA, and MRI were reportedly normal and the biopsies were ultimately negative. He then presented this admission with gait instability and MRI exhibited a diffusion restricting lesion with T2-FLAIR hyperintensity without hemorrhage in the left cerebral peduncle. His visual symptoms progressed and he underwent right eye anterior chamber paracentesis with fluid resulting PCR positive for HSV-2. Subsequent CSF sampling also revealed lymphocytic pleocytosis and HSV-2 positivity. Despite maximal medical therapy, he lost vision in both eyes over a matter of weeks before developing Charles-Bonnet syndrome.Conclusions: HSV-2 encephalitis may cause mesencephalic, non-hemorrhagic, restricting lesions mimicking acute ischemic stroke. HSV may also cause a necrotizing retinitis, initially mimicking ischemic, even arteritic, optic neuropathy.Disclosure: Dr. Sutherland has received personal compensation in the range of $0-$499 for serving as a Consultant for McGraw-Hill. Dr. Gummerson has nothing to disclose. Dr. De Havenon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Integra. Dr. De Havenon has stock in Certus. The institution of Dr. De Havenon has received research support from NIH/NINDS. The institution of Dr. De Havenon has received research support from Regeneron Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMAG Pharmaceuticals. The institution of Dr. De Havenon has received research support from AMGEN. Dr. De Havenon has received publishing royalties from a publication relating to health care. ER -