Acute Hemorrhagic Necrotizing Encephalopathy in a COVID-19 Patient With a  Response to Intravenous Immunoglobulin Therapy

Fajer Saleh Almeer; Heba Khalid Alkoheji; Marwa Ebrahim Zayed; Ali Jaffar Al-Hilly; Omar Abduljabar Hussein

doi:10.12659/AJCR.949542

12 February 2026 : Case report Bahrain

Acute Hemorrhagic Necrotizing Encephalopathy in a COVID-19 Patient With a Response to Intravenous Immunoglobulin Therapy

Challenging differential diagnosis, Rare disease

Fajer Saleh Almeer^{ABCDEFG 1*}, Heba Khalid Alkoheji^{ABCDEFG 2}, Marwa Ebrahim Zayed^{ABCDEFG 3}, Ali Jaffar Al-Hilly^{ABCDEFG 3}, Omar Abduljabar Hussein^{ABCDEFG 3}

DOI: 10.12659/AJCR.949542

Am J Case Rep 2026; 27:e949542

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Figure 1 Diffusion restriction of bilateral thalamic lesion in acute hemorrhagic necrotizing encephalitis (AHNE)Axial diffusion-weighted imaging (DWI) sequences demonstrate high signal intensity in the bilateral thalami (red arrows), with corresponding low signal intensity on apparent diffusion coefficient (ADC) maps (blue arrows). These findings are consistent with cytotoxic edema and inflammatory changes characteristic of AHNE.

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Acute Hemorrhagic Necrotizing Encephalopathy in a COVID-19 Patient With a Response to Intravenous Immunoglobulin Therapy

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