Acute Hemorrhagic Leukoencephalitis and Hypoxic Brain Injury Associated With H1N1 Influenza | Infectious Diseases | JAMA Neurology | JAMA Network
[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.207.108.182. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Observation
June 2010

Acute Hemorrhagic Leukoencephalitis and Hypoxic Brain Injury Associated With H1N1 Influenza

Author Affiliations

Author Affiliations: Department of Neurology, Mayo Clinic, Rochester, Minnesota.

Arch Neurol. 2010;67(6):756-758. doi:10.1001/archneurol.2010.122
Abstract

Objective  To describe the first adult with neurologic complications associated with H1N1 influenza virus infection.

Design  Case report.

Patient  A 40-year-old man with severe H1N1 influenza infection with prolonged hypoxia and critical illness who remained comatose after withdrawal of sedatives and paralytics.

Interventions  Clinical examination and magnetic resonance imaging.

Results  Brain imaging revealed multifocal T2 hyperintense lesions, edema, and hemorrhages consistent with acute hemorrhagic leukoencephalitis (AHL) and restricted diffusion in the basal ganglia consistent with hypoxic brain injury. The patient remained in a severely disabled state following treatment with plasma exchange and high-dose corticosteroids.

Conclusions  This is the first study of neurologic complications associated with H1N1 influenza infection in adults. Severe brain injury can occur by 2 distinct mechanisms: a fulminant autoimmune demyelinating insult (AHL) and hypoxic brain injury. Clinicians should be aware of these potential complications so that appropriate imaging and treatment can be considered.

×