Reversal of parkinsonism and portosystemic encephalopathy following embolization of a congenital intrahepatic venous shunt: brain MR imaging and 1H spectroscopic findings.
Parkinsonism and portosystemic encephalopathy (PSE) are cerebral disorders associated with motor and neuropsychological dysfunctions that may occur in patients with chronic liver disease. We describe a patient with parkinsonism and neuroradiologic and 1H spectroscopic findings of PSE associated with a large congenital intrahepatic portosystemic venous shunt. Chronic liver disease was absent. After endovascular treatment, we documented a progressive reversal of parkinsonism and PSE on the basis of clinical, neuroradiologic, and spectroscopic criteria.
Centro de Medicina Diagnóstica, Setor de Imagem, Laboratório Fleury, São Paulo Brazil.
Antônio J
AJ
da Rocha
Flávio T
FT
Braga
Carlos J
CJ
da Silva
Antônio C M
AC
Maia
Guilherme S
GS
Mourão
Rubens J
RJ
Gagliardi
D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006501:Hepatic Encephalopathy / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006503:Hepatic Veins / Q000002:abnormalities / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011169:Portal Vein / Q000002:abnormalities / Q000473:pathology; D016896:Treatment Outcome