Clinical recovery of severe infantile Angiostrongylus cantonensis meningoencephalomyelitis treated with pulse methylprednisolone: A case report and review of literature

Figure 1 Initial neuroimaging findings. A: Axial T2-weighted brain magnetic resonance imaging showing diffuse bilateral hyperintense lesions involving the gray and white matter of the frontal, parietal, and occipital lobes with associated ventricular dilatation. No acute hemorrhage, mass effect, or significant ventriculomegaly was detected; B: Sagittal T2-weighted cervical spine magnetic resonance imaging (MRI) revealing longitudinal hyperintense signal from C3 to C6 with mild cord expansion consistent with inflammatory edema; C: Axial T2-weighted cervical spine MRI demonstrating symmetric anterior horn hyperintensity, correlating with flaccid quadriplegia and respiratory failure. The orange arrows indicate the lesion locations in the brain and cervical spine.

Figure 2 Pre-discharge and follow-up magnetic resonance imaging findings. Pre-discharge brain magnetic resonance imaging demonstrating a thin right-sided subdural hygroma along the cerebral convexity and persistent ventriculomegaly as residual treatment-related sequelae. The orange arrows indicate the lesion locations in the brain.

Figure 3 Follow-up magnetic resonance imaging findings. A: Brain magnetic resonance imaging (MRI) at 17 months of age showing marked reduction in lateral ventricular size (8 mm vs 12 mm at admission), complete resolution of the subdural hygroma, and normal brain parenchyma with preserved cortical sulci. Ventricular enlargement is indicated by an asterisk; B: Cervical spine MRI demonstrating normal spinal cord signal from C3 to C6 without evidence of cord atrophy. The orange arrows indicate the lesion locations in the brain and cervical spine.