Acute Hepatic Encephalopathy Presenting as Cortical Laminar Necrosis: Case Report.
10.3348/kjr.2013.14.2.324
- Author:
Jong Mun CHOI
1
;
Yoon Hee KIM
;
Sook Young ROH
Author Information
1. Department of Radiology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam 463-774, Korea. janet@dmc.or.kr
- Publication Type:Case Reports
- Keywords:
Acute hepatic encephalopathy;
Cortical laminar necrosis;
Cirrhosis;
Magnetic resonance imaging
- MeSH:
Ammonia/blood;
Atrophy/pathology;
Brain Diseases/blood/*diagnosis/*etiology;
Hepatic Encephalopathy/*complications;
Humans;
Liver Cirrhosis, Alcoholic/*complications;
Magnetic Resonance Imaging/*methods;
Male;
Middle Aged;
Necrosis/pathology;
Status Epilepticus/pathology
- From:Korean Journal of Radiology
2013;14(2):324-328
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report on a 55-year-old man with alcoholic liver cirrhosis who presented with status epilepticus. Laboratory analysis showed markedly elevated blood ammonia. Brain magnetic resonance imaging (MRI) showed widespread cortical signal changes with restricted diffusion, involving both temporo-fronto-parietal cortex, while the perirolandic regions and occipital cortex were uniquely spared. A follow-up brain MRI demonstrated diffuse cortical atrophy with increased signals on T1-weighted images in both the basal ganglia and temporal lobe cortex, representing cortical laminar necrosis. We suggest that the brain lesions, in our case, represent a consequence of toxic effect of ammonia.
