What is the role of CT scanning in the workup of herpes simplex encephalitis (HSE)?

Updated: Jul 17, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Approximately one third of patients with HSE have normal CT findings on presentation. Head CT may show changes in the temporal and/or frontal lobe, but CT is less sensitive than MRI.

Low-density lesions may be found in two thirds of cases, especially in the temporal lobes, but they may not appear until 3-4 days after onset. Edema and hemorrhages may be present. After 1 week, contrast enhancement may be detectable.


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