{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T13:47:43Z","timestamp":1762609663144,"version":"3.37.3"},"reference-count":9,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Chikungunya is a mosquito-borne disease caused by the chikungunya virus (CHIKV) and can lead to neurological complications in severe cases.<\/jats:p><jats:p>\n          Objective\u2003This study examined neuroimaging patterns in chikungunya cases during two outbreaks in Brazil to identify specific patterns for diagnosis and treatment of neuro-chikungunya.<\/jats:p><jats:p>\n          Methods\u2003Eight patients with confirmed chikungunya and neurological involvement were included. Clinical examinations and MRI scans were performed, and findings were analyzed by neuroradiologists. Data on age, sex, neurological symptoms, diagnostic tests, MRI findings, and clinical outcomes were recorded.<\/jats:p><jats:p>\n          Results\u2003Patients showed different neuroimaging patterns. Six patients exhibited a \u201cclock dial pattern\u201d with hyperintense dotted lesions in the spinal cord periphery. One patient had thickening and enhancement of anterior nerve roots. Brain MRI revealed multiple hyperintense lesions in the white matter, particularly in the medulla oblongata, in six patients. One patient had a normal brain MRI.<\/jats:p><jats:p>\n          Conclusion\u2003The \u201cclock dial pattern\u201d observed in spinal cord MRI may be indicative of chikungunya-related nervous system lesions. Isolated involvement of spinal cord white matter in chikungunya can help differentiate it from other viral infections. Additionally, distinct brainstem involvement in chikungunya-associated encephalitis, particularly in the rostral region, sets it apart from other arboviral infections. Recognizing these neuroimaging patterns can contribute to early diagnosis and appropriate management of neuro-chikungunya.<\/jats:p>","DOI":"10.1055\/s-0044-1779033","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:43:59Z","timestamp":1706575439000},"page":"001-006","source":"Crossref","is-referenced-by-count":3,"title":["\u201cClock dial pattern\u201d, a radiologic clue to neuro-chikungunya diagnosis: a case series"],"prefix":"10.1055","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5250-8602","authenticated-orcid":false,"given":"Pedro Henrique Almeida","family":"Fraiman","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Neurologia, Natal RN, Brazil."},{"name":"Universidade Federal de S\u00e3o Paulo, Departamento de Neurologia e Neurocirurgia, S\u00e3o Paulo SP, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2028-7662","authenticated-orcid":false,"given":"Mariana","family":"Freire","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Radiologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6186-5193","authenticated-orcid":false,"given":"Bruno","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Neurologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9932-5757","authenticated-orcid":false,"given":"Felipe","family":"Palitot","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Radiologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0631-396X","authenticated-orcid":false,"given":"Nathalia","family":"Mota","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Radiologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2122-9843","authenticated-orcid":false,"given":"Eduardo","family":"Sequerra","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Instituto do C\u00e9rebro, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-6806","authenticated-orcid":false,"given":"Glauco","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Giselda Trigueiro, Divis\u00e3o de Infectologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-2294","authenticated-orcid":false,"given":"Mario Emilio","family":"Dourado","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Neurologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4312-1633","authenticated-orcid":false,"given":"Clecio de Oliveira","family":"Godeiro-Junior","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Neurologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3478-5323","authenticated-orcid":false,"given":"Manuel","family":"Moreira-Neto","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte, Hospital Universit\u00e1rio Onofre Lopes, Divis\u00e3o de Radiologia, Natal RN, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"publisher","first-page":"e1978","DOI":"10.1002\/rmv.1978","article-title":"The neurological complications of chikungunya virus: A systematic review","volume":"28","author":"R Mehta","year":"2018","journal-title":"Rev Med Virol"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1590\/0004-282x20160138","article-title":"Neurological manifestations of Chikungunya and Zika infections","volume":"74","author":"T J Pinheiro","year":"2016","journal-title":"Arq Neuropsiquiatr"},{"issue":"03","key":"ref4","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1590\/0037-8682-0259-2017","article-title":"Encephalitis and transverse myelitis in dengue and chikungunya 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