Journal of Medical Disorders

Journal of Medical Disorders

ISSN 2053-3659
Case report

Transcranial doppler findings in a case of rabies encephalitis

Aarti Sarwal1*, Joshua Botdorf2, Christopher R. Newey3 and Manjamalai Sivaraman4

*Correspondence: Aarti Sarwal asarwal@wakehealth.edu

1. Department of Anesthesiology, Section on Critical Care, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Author Affiliations

2. Division of Nephrology, Department of Internal Medicine, University of Missouri, Columbia, USA.

3. Department of Neurology, University of Chicago, 5841 S. Maryland Avenue, Chicago, USA.

4. Department of Neurology, University of Missouri, Columbia, USA.

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Abstract

Rabies encephalitis is a uniformly fatal disease with several hypothesis proposed to explain pathogenesis and mortality. One such theory premises deficiency of neuronal nitric oxide synthetase deficiency causing selective cerebral vasospasm. We present transcranial Doppler findings in a case of rabies that did not show imaging evidence of vasospasm. Transcranial Doppler in two published cases have reported occurrence of global vasospasm. Our case showed no sonographic vasospasm in middle cerebral arteries but consistently increased distal resistance indices likely due to cerebral edema. While vasospasm may occur in rabies, cerebral edema secondary to disease or pharmacological interventions confounds transcranial Doppler readings. Cerebral angiogram and multimodality monitoring is encouraged.

Keywords: Rabies encephalitis, vasospasm, transcranial doppler, cerebral edema

ISSN 2053-3659
Volume 2
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