Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy

Autores
Varela, Francisco Javier; Chaves, Hernan; Rossi, Malco Damian
Año de publicación
2023
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
An 80-year-old woman presented to the emergency department with vertigo, right hand incoordination, and postural instability 5 months after rituximab treatment for chronic lymphocytic leukemia. Physical examination revealed dysarthria, horizontal nystagmus, gait ataxia, and right upper and lower limb dysmetria. Brain magnetic resonance imaging showed a T2 hyperintense (Figure, A) and T1 hypointense (Figure, B) lesion in the right cerebellar white matter that demarcates the dentate nucleus (Figure, C), with pontine and middle cerebellar peduncle extension. This imaging finding corresponds to the “shrimp sign”: white matter lesion that preserves the curvilinear-shaped dentate nucleus, giving a shrimp-like appearance.1 HIV serologic testing was negative, and JC virus DNA was detected in the CSF, establishing the diagnosis of HIV-negative progressive multifocal leukoencephalopathy (PML). Rituximab was discontinued, and she showed no radiologic and clinical progression after 1-year follow-up. The “shrimp sign” is a reliable indicator of infratentorial PML in patients with cerebellar ataxia.
Fil: Varela, Francisco Javier. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
Fil: Chaves, Hernan. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
Fil: Rossi, Malco Damian. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
Shrimp
Ataxic
Cerebellar
Leukoencephalopathy
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/255994
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/255994
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal LeukoencephalopathyVarela, Francisco JavierChaves, HernanRossi, Malco DamianShrimpAtaxicCerebellarLeukoencephalopathyhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3An 80-year-old woman presented to the emergency department with vertigo, right hand incoordination, and postural instability 5 months after rituximab treatment for chronic lymphocytic leukemia. Physical examination revealed dysarthria, horizontal nystagmus, gait ataxia, and right upper and lower limb dysmetria. Brain magnetic resonance imaging showed a T2 hyperintense (Figure, A) and T1 hypointense (Figure, B) lesion in the right cerebellar white matter that demarcates the dentate nucleus (Figure, C), with pontine and middle cerebellar peduncle extension. This imaging finding corresponds to the “shrimp sign”: white matter lesion that preserves the curvilinear-shaped dentate nucleus, giving a shrimp-like appearance.1 HIV serologic testing was negative, and JC virus DNA was detected in the CSF, establishing the diagnosis of HIV-negative progressive multifocal leukoencephalopathy (PML). Rituximab was discontinued, and she showed no radiologic and clinical progression after 1-year follow-up. The “shrimp sign” is a reliable indicator of infratentorial PML in patients with cerebellar ataxia.Fil: Varela, Francisco Javier. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Chaves, Hernan. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Rossi, Malco Damian. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaLippincott Williams2023-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/255994Varela, Francisco Javier; Chaves, Hernan; Rossi, Malco Damian; Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy; Lippincott Williams; Neurology; 101; 20; 11-2023; 918-9190028-38781526-632XCONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1212/WNL.0000000000207868info:eu-repo/semantics/altIdentifier/url/https://www.neurology.org/doi/10.1212/WNL.0000000000207868info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-02-06T12:03:43Zoai:ri.conicet.gov.ar:11336/255994instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-02-06 12:03:43.366CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
title Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
spellingShingle Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
Varela, Francisco Javier
Shrimp
Ataxic
Cerebellar
Leukoencephalopathy
title_short Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
title_full Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
title_fullStr Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
title_full_unstemmed Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
title_sort Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy
dc.creator.none.fl_str_mv Varela, Francisco Javier
Chaves, Hernan
Rossi, Malco Damian
author Varela, Francisco Javier
author_facet Varela, Francisco Javier
Chaves, Hernan
Rossi, Malco Damian
author_role author
author2 Chaves, Hernan
Rossi, Malco Damian
author2_role author
author
dc.subject.none.fl_str_mv Shrimp
Ataxic
Cerebellar
Leukoencephalopathy
topic Shrimp
Ataxic
Cerebellar
Leukoencephalopathy
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv An 80-year-old woman presented to the emergency department with vertigo, right hand incoordination, and postural instability 5 months after rituximab treatment for chronic lymphocytic leukemia. Physical examination revealed dysarthria, horizontal nystagmus, gait ataxia, and right upper and lower limb dysmetria. Brain magnetic resonance imaging showed a T2 hyperintense (Figure, A) and T1 hypointense (Figure, B) lesion in the right cerebellar white matter that demarcates the dentate nucleus (Figure, C), with pontine and middle cerebellar peduncle extension. This imaging finding corresponds to the “shrimp sign”: white matter lesion that preserves the curvilinear-shaped dentate nucleus, giving a shrimp-like appearance.1 HIV serologic testing was negative, and JC virus DNA was detected in the CSF, establishing the diagnosis of HIV-negative progressive multifocal leukoencephalopathy (PML). Rituximab was discontinued, and she showed no radiologic and clinical progression after 1-year follow-up. The “shrimp sign” is a reliable indicator of infratentorial PML in patients with cerebellar ataxia.
Fil: Varela, Francisco Javier. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
Fil: Chaves, Hernan. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
Fil: Rossi, Malco Damian. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description An 80-year-old woman presented to the emergency department with vertigo, right hand incoordination, and postural instability 5 months after rituximab treatment for chronic lymphocytic leukemia. Physical examination revealed dysarthria, horizontal nystagmus, gait ataxia, and right upper and lower limb dysmetria. Brain magnetic resonance imaging showed a T2 hyperintense (Figure, A) and T1 hypointense (Figure, B) lesion in the right cerebellar white matter that demarcates the dentate nucleus (Figure, C), with pontine and middle cerebellar peduncle extension. This imaging finding corresponds to the “shrimp sign”: white matter lesion that preserves the curvilinear-shaped dentate nucleus, giving a shrimp-like appearance.1 HIV serologic testing was negative, and JC virus DNA was detected in the CSF, establishing the diagnosis of HIV-negative progressive multifocal leukoencephalopathy (PML). Rituximab was discontinued, and she showed no radiologic and clinical progression after 1-year follow-up. The “shrimp sign” is a reliable indicator of infratentorial PML in patients with cerebellar ataxia.
publishDate 2023
dc.date.none.fl_str_mv 2023-11
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/255994
Varela, Francisco Javier; Chaves, Hernan; Rossi, Malco Damian; Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy; Lippincott Williams; Neurology; 101; 20; 11-2023; 918-919
0028-3878
1526-632X
CONICET Digital
CONICET
url http://hdl.handle.net/11336/255994
identifier_str_mv Varela, Francisco Javier; Chaves, Hernan; Rossi, Malco Damian; Teaching NeuroImage: Shrimp Sign in Ataxic Cerebellar Progressive Multifocal Leukoencephalopathy; Lippincott Williams; Neurology; 101; 20; 11-2023; 918-919
0028-3878
1526-632X
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1212/WNL.0000000000207868
info:eu-repo/semantics/altIdentifier/url/https://www.neurology.org/doi/10.1212/WNL.0000000000207868
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Lippincott Williams
publisher.none.fl_str_mv Lippincott Williams
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.106097

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