Epilepsy, hippocampal sclerosis and amygdalar atrophy following H1N1-influenza- associated encephalopathy in an adult Shirin Karimi, Taufik A. Valiante,

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Epilepsy, hippocampal sclerosis and amygdalar atrophy following H1N1-influenza- associated encephalopathy in an adult Shirin Karimi, Taufik A. Valiante, Tim-Rasmus Kiehl Human Pathology: Case Reports Volume 2, Issue 4, Pages 106-109 (December 2015) DOI: 10.1016/j.ehpc.2015.06.001 Copyright © 2015 The Authors Terms and Conditions

Fig. 1 Neuroimaging 5 years after the acute illness and neuropathological findings. (A) Axial T1 MRI scan showing significant volume loss of the right amygdala with corresponding distention of the right temporal horn. (B) Axial T1 demonstrating mild generalized cerebral volume loss with no lobar predilection. (C) Coronal T2 FLAIR image with hyperintensity of the right hippocampal formation and amygdala. (D) Area CA4 of the hippocampal pyramidal layer shows extensive neuronal loss and gliosis (10× magnification; all scale bars = 100 mcm). (E) Focal perivascular lymphoid infiltrate around sclerotic blood vessel in the temporal white matter (20×). (F) Blood vessels in white matter with thickened vessel walls, marked perivascular clearing and hemosiderin (10×). (G) Immunohistochemistry for GFAP on a section from temporal cortex showing marked gliosis (20×). (H) CD3 highlighting occasional perivascular T-cells (20×). (I) CD4 stain in cortex demonstrating activated microglia (20×). Human Pathology: Case Reports 2015 2, 106-109DOI: (10.1016/j.ehpc.2015.06.001) Copyright © 2015 The Authors Terms and Conditions