Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Acute Hepatic Encephalopathy Presenting as Cortical Laminar Necrosis: Case Report

  • Choi, Jong Mun (Department of Radiology, Bundang Jesaeng General Hospital, Daejin Medical Center) ;
  • Kim, Yoon Hee (Department of Radiology, Bundang Jesaeng General Hospital, Daejin Medical Center) ;
  • Roh, Sook Young (Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center)
  • Published : 2013.04.01
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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.

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References

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