Pseudotumoral lesion as a manifestation of acute hemorrhagic leukoencephalitis (Weston-Hurst syndrome)

A case of acute hemorrhagic encephalomyelitis whose first manifestation was a pseudotumoral lesion in the corpus callosum is presented. The patient had an acute headache accompanied by visual hallucinations and subsequently developed convulsive status epilepticus. The initial CT scan showed a lesion with a pseudotumoral aspect in the splenius of the corpus callosum. Multiple microbleeds in the same location associated with vasogenic edema were seen in the MRI. A brain biopsy was necessary to obtain an accurate diagnosis. Corticosteroid management resulted in only a partial response. Weston Hurst syndrome is a variant of acute disseminated encephalomyelitis (ADEM) with an unfavorable prognosis.