Abstract Details

Title Cerebellar, Hippocampal, and Basal Nuclei Transient Edema with Restricted Diffusion (CHANTER) Syndrome: An Imitation of Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-018

Objective Cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) syndrome is a recently described novel disease entity that remains rarely reported in neurological literature. Here we report a case of CHANTER syndrome. Our objective is to share clinical and imaging data to support a more accurate recognition and diagnostic consideration of this recently described condition.

Background

CHANTER syndrome, first described in 2019. It is a rare clinical and radiological entity which could be mistaken as an ischemic stroke; however, its distribution is non-vascular territory. There is a strong relation with CHANTER syndrome and polysubstance abuse, particularly opioid intoxication.

Design/Methods NA

Results A 43 y.o. female with a past medical history of depression, hypertension, and opioid dependence on methadone who presented with unresponsiveness and foamy vomitus in the mouth. She had three cardiac arrests, regaining spontaneous circulation after a single round of epinephrine and cardiopulmonary resuscitation each time. She required to be intubated, and was mechanically ventilated for three days. She was also hypoglycemic and was treated with dextrose. Following extubation, the patient developed weakness and confusion; neurology was consulted to rule out stroke or hypoxic brain injury. Brain magnetic resonance imaging (MRI) showed symmetrically restricted diffusion at bilateral cerebellum, basal ganglia, hippocampi, right frontal and left parietal lobe, suggesting CHANTER syndrome in light of opioid toxicity. MRI was negative for acute stroke or anoxic brain injury. Computerized tomography imaging of head and Neck was negative for large vessel occlusion or stenosis. Troponin was elevated, but ACS was ruled out.

Conclusions This case highlights the clinical entity of CHANTER syndrome, a rare opioid-related condition that can mimic ischemic stroke. Reporting this case in the neurology literature will potentially help to recognize this new entity and differentiate it from ischemic stroke , and contribute to optimal patient management

Authors/Disclosures
Maria I. Bonilla PRESENTER	Miss Bonilla has nothing to disclose.
Kaushik Avadhanula, Undergraduate	Mr. Avadhanula has nothing to disclose.
Shyamal C. Bir, MD (Tallahassee Memorial Hospital)	Dr. Bir has nothing to disclose.

��ɫ��

��ɫ��