Acquired hepatocerebral degeneration

Case contributed by James Harvey
Diagnosis almost certain

Presentation

Unwitnessed falls. History of cirrhosis and portal hypertension secondary to chronic alcohol excess. Portal vein thrombosis.

Patient Data

Age: 65 years
Gender: Male
This study is a stack
Axial
T1
This study is a stack
Coronal
T1
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Sagittal
T1
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Axial
T2
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Sagittal
T2
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Axial
FLAIR
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Axial
SWI
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Axial
DWI
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Info
  • Symmetrical high T1 signal is seen within the globi pallidi, the ventral thalami, and the cerebral peduncles
  • Age advanced cerebral atrophy

Case Discussion

In this case, where there is supportive history of cirrhosis, acquired hepatocerebral degeneration is the most likely cause.

Manganese overload from other causes such as total parenteral nutrition could have the same appearance.

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