Question 469
{"accessible":false,"alternatives":[{"id":2353,"text":"diffusion restriction"},{"id":2354,"text":"increased T2 signal"},{"id":2355,"text":"involvement of frontal operculum"},{"id":2356,"text":"MRI T1 enhancement in subacute phase"},{"id":2357,"text":"sparing of the basal ganglia"},{"id":2358,"text":"unremarkable CT in early phase"}],"archived":false,"correctAlternativeId":2357,"explanation":"\u003cp\u003eIn the immunocompetent adult patient with HSV encephalitis, the pattern is quite typical and manifests as a bilateral asymmetrical involvement of the limbic system, medial temporal lobes, insular cortices and inferolateral frontal lobes. The basal ganglia are typically spared, helping to distinguish it from a middle cerebral artery infarct.\u003c/p\u003e\u003cp\u003eAll other features are also seen in MCA infarction.\u0026nbsp;\u003c/p\u003e","id":469,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2132","nextQuestionPath":"/articles/herpes-simplex-encephalitis/questions/468","relatedArticles":[{"id":1617,"title":"Middle cerebral artery (MCA) infarct","link":"/articles/middle-cerebral-artery-mca-infarct?lang=us"}],"alsoUsedIn":[{"id":784,"kind":"Course","title":"Stroke Learning Pathway - page 784","link":"https://radiopaedia.org/courses/stroke-learning-pathway/pages/784"},{"id":1177,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1177","link":"https://radiopaedia.org/courses/adult-neuroradiology-review-course/pages/1177"},{"id":1177,"kind":"Course","title":"Adult Neuroradiology Review Course - page 1177","link":"https://radiopaedia.org/courses/adult-brain-mri-review-course-2015-online-video/pages/1177"},{"id":1469,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1469","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1469"},{"id":1469,"kind":"Course","title":"CT \u0026 MRI Lectures - page 1469","link":"https://radiopaedia.org/courses/ct-mri-lectures/pages/1469"},{"id":2121,"kind":"Course","title":"Stroke Learning Pathway - peer review - page 2121","link":"https://radiopaedia.org/courses/stroke-learning-pathway-peer-review/pages/2121"}],"stem":"\u003cp\u003eWhich of the following features is helpful in distinguishing herpes simplex encephalitis from middle cerebral artery infarction?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/469"}],"attemptsPercentages":[{"alternativeId":"2357","percentage":73},{"alternativeId":"2355","percentage":5},{"alternativeId":"2353","percentage":10},{"alternativeId":"2354","percentage":4},{"alternativeId":"2356","percentage":5},{"alternativeId":"2358","percentage":3}],"promptToLogin":false,"questionManager":false,"articleId":"herpes-simplex-encephalitis"}