Presentation
Headache, parkinsonian features.
Patient Data
Age: 60 years
Gender: Male
From the case:
Acquired hepatocerebral degeneration
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Nearly symmetrical T1 hyperintensities are seen in bilateral globi palladi, ventrolateral thalami, and possibly in the substantia nigra of the midbrain. There is a sparing of right nuclei, cerebellum, and putamen
Gliotic areas are seen in the right parietal and temporal lobes, likely sequelae of trauma.
Focal chronic lacunar infarct is seen in the subcortical white matter of the right frontoparietal lobe.
Note is made of mucosal thickening in bilateral maxillary sinuses.
Case Discussion
The patient is a known case of hepatic cirrhosis. In this context, MRI findings are consistent with acquired hepatocerebral degeneration. The T1 hyperintensities are due to deposition of manganese.
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