Presentation
Chronic liver dysfunction,
Patient Data
Age: 35 years
Gender: Male
From the case:
Hyperammonemic encephalopathy
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Edema/hyperintensity is seen predominantly involving the cortex in bilateral temporal lobes and left frontoparietal lobes. Diffusion restriction is seen in the bilateral insular cortex, hippocampi / medial temporal lobes, and frontoparietal lobes.
Subtle T2/FLAIR hyperintensities are seen in bilateral thalami and right basal ganglia.
Chronic lacunar infarcts / nonspecific hyperintensities are seen in subcortical white matter of bilateral frontoparietal lobes.
Case Discussion
The patient is a known case of chronic liver disease and was found to have increased serum ammonia levels. The MRI findings are consistent with hyperammonemic encephalopathy.
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