PMC10374307_01
Brain magnetic resonance imaging at first administration. (A) T1-weighted image. (B) T2-weighted image. (C) Flair sequence. (D) Gadolinium-enhanced T1-weighted image of the right temporal lobe. (E) Gadolinium-enhanced T1-weighted image of the transverse sinus. The white arrow indicates the filling defect of right transverse sinus. (F) MRV scanning. The black arrow indicates the interruption of blood flow at the junction of the right Labbe vein and right transverse sinus.
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F1
Gadolinium-enhanced T1-weighted image further confirmed the clogging in the vein (Figure 1).
PMC10374307_02
Indirect immunofluorescence assay of autoimmune encephalitis antibodies. (A) Cell based assay of NMDAR antibody in blood (1:10 titer). (B) Cell based assay of GABABR antibody in blood (1:10 titer). (C) Tissue based assay for blood antibodies against monkey cerebellum. (D) Cell based assay of NMDAR antibody in CSF (1:10 titer). (E) Cell based assay of GABABR antibody in CSF (1:1 titer). (F) Tissue based assay for CSF antibodies against monkey cerebellum.
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F2
At this time, autoimmune encephalitis antibody analysis showed that both NMDA receptor antibody and GABAB receptor antibodywere positive in the blood (NMDAR receptor antibody titer 1:10, GABAB receptor antibody titer 1:10) and CSF (NMDA receptor antibody titer 1:10, GABAB receptor antibody titer 1:1) (Figure 2).
Brain magnetic resonance imaging at follow-up. (A) Flair sequence before discharge. (B) MRV scanning at four-month follow-up. The black arrow indicates the interruption of blood flow at the junction of the right Labbe vein and right transverse sinus. (C) Flair sequence at four-month follow-up.
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F3
The right temporal lobe lesion was partially absorbed on a follow-up brain MRI scanning before discharge (Figure 3A). The stenosis at the junction of the right Labbe vein and transverse sinus remained unchanged and the right temporal lobe lesion nearly completely disappeared (Figures 3B, C).