Diagnostic Value of The “Insular Knife‐Cut” Sign in Patients With Suspected Herpes Simplex Virus Encephalitis

European Journal of Neurology  ·  2025

Sofia Marini; Maria Luisa Usai; S. Falso; Davide Turilli; Sabrine Othmani; Rossella Meloni; Pietro Businaro; Giacomo Greco; M. Puci; Martina Marini; A. Pichiecchio; M. Paoletti; Pietro Zara; Salvatore Masala; G. Sotgiu; M. Gastaldi; P. Solla; Raffaele Iorio; Elia Sechi;

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ABSTRACT

The “insular knife‐cut” sign is a sharp demarcation between hyperintense insular lesions on fluid‐attenuated inversion recovery axial images and the basal ganglia, detected on brain MRI. This sign has been associated with herpes simplex virus encephalitis (HSVE); however, its specificity remains unknown. We assessed the frequency and specificity of the insular knife‐cut sign in a real‐life cohort of patients with suspected HSVE.

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