Presentation
Previous history of viral illness. Presented with high fever and vomiting, confusion and ataxia.
Patient Data
An ill-defined area of hypodensity is noted involving the right medial temporal lobe with loss of grey-white differentiation and effacement of sulci. No hemorrhage/midline shift.
Case Discussion
Herpes encephalitis is a common type of viral encephalitis and usually involves the limbic system and medial temporal lobe of the brain. Sparing of basal ganglia is helpful in differentiating it from most middle cerebral artery infarcts. Patients usually do not have any motor weakness and bilateral involvement is common (not obviously the case in this instance).
Unfortunately, no corroborating evidence is available, nor is any additional imaging.
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