title: Acute hepatic encephalopathy presenting as cortical laminar necrosis: case report.
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.
authors.affiliation: Department of Radiology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam 463-774, Korea.
authors.forename: Jong Mun
authors.initials: JM
authors.lastname: Choi
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Roh
mesh_terms: D000641:Ammonia / Q000097:blood; D001284:Atrophy / Q000473:pathology; D001927:Brain Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D006501:Hepatic Encephalopathy / Q000150:complications*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D013226:Status Epilepticus / Q000473:pathology
chemical_list: D000641:Ammonia
keywords: Acute hepatic encephalopathy; Cirrhosis; Cortical laminar necrosis; Magnetic resonance imaging