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Imágenes Médicas.: Evolución Cronológica de la Encefalopatía Hepática...

Imágenes Médicas.: Evolución Cronológica de la Encefalopatía Hepática...: "Evolución Cronológica de la Encefalopatía Hepática"

Evolución Cronológica de la Encefalopatía Hepática

Evolución Cronológica de la Encefalopatía Hepática

Wernicke's encephalopathy

This MRI shows typical high signal intensities (SIs) in the medial thalamus (A), periaqueductal gray (B), mamillary bodies (C), cerebellar vermis (B, C, D), and paravermian superior cerebellum (D). All the lesions represent high SIs on the DWI (E–H). The ADC images of the cerebellar vermis (K, L) and paravermian superior cerebellum (L) show low SIs (arrowheads), whereas other described areas (I, J) show iso-SIs (arrows). Image courtesy of Neurology. Apr 8 2008;70(15):e48.

A 20-year-old pregnant female with severe emesis and presumed Wernicke's encephalopathy. Flair images demonstrate typical findings of hyperintensity in the periaqueductal region of the midbrain (A), mammillary bodies (B), and thalamus (C). Additionally, the patient had bilateral symmetrical hyperintensity in the frontal-parietal cortices (D), which has also been reported in these patients.  
 
 
 

Diffusion- weighted imaging (A) and ADC map (B) show restricted diffusion in the thalami, suggestive of cytotoxic edema. Other reports show hyperintensity on diffusion images without restriction seen on ADC maps, more suggestive of vasogenic edema. The underlying pathology and prognostic significance of diffusion findings are unclear. Post- contrast images (C) indicate breakdown of the blood-brain barrier with enhancement of the mammillary bodies. Courtesy Eric D Schwartz, MD.

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Hospital Dr. Angel Pintos de Azul.

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