好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Reversible Diffusion-Restricting White Matter Lesions Associated with Pain Crisis in Sickle Cell Disease: A Case Report
Cerebrovascular Disease and Interventional Neurology
P3 - Poster Session 3 (11:45 AM-12:45 PM)
14-008
N/A
Neurological and cerebrovascular complications are relatively common in patients with sickle cell disease (SCD). Three main categories include large vessel infarctions, silent infarctions, and hemorrhage. Here we present a rare case of reversible, diffuse white matter lesions associated with severe neurological dysfunction. 
N/A

An 18-year-old African American man with SCD presented with acute pain crisis and fevers. He was treated with antibiotics and analgesics but developed worsening hypoxemia and mental status, requiring intubation. MRI brain showed diffuse restricted diffusion and FLAIR hyperintensities symmetrically involving bilateral cerebral deep white matter and splenium of the corpus callosum. MRA head was unremarkable, EEG showed no seizures, and CSF analysis was unremarkable. The patient was treated with hydroxyurea, voxelotor, exchange transfusion, and analgesics. Following extubation, the neurological exam remained poor with no verbal output, inability to follow commands, and spastic quadriparesis. The patient was eventually discharged to a rehabilitation facility. Monthly exchange transfusions were continued. Three months later, his neuro exam showed marked clinical improvement and near-complete resolution of subcortical and splenial white matter abnormalities on MRI. Six months later he was back to his neurological baseline.
SCD is known to cause several cerebrovascular complications. This case report highlights a rare complication of SCD that presents with severe neurologic dysfunction with cerebral vaso-occlusive crisis involving white matter that is reversible with treatment. 
Authors/Disclosures
Meyer Herzog
PRESENTER 		Mr. Herzog has nothing to disclose.
Esewi Aifuwa, Medical Student Mr. Aifuwa has nothing to disclose.
Joseph Quintas Dr. Quintas has nothing to disclose.
Sana Ali, MD Dr. Ali has nothing to disclose.
Amir Steinberg, MD Dr. Steinberg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen . Dr. Steinberg has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Jazz.
Tomoko Kitago, MD (Westchester Medical Center) Dr. Kitago has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MindMaze. The institution of Dr. Kitago has received research support from American Speech-Language Hearing Foundation. The institution of Dr. Kitago has received research support from National Institutes of Health.