Deterioration of conscious level and agitation. Patient had gastric surgery 2 months ago for peptic ulcer.
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Abnormal signal bilateral and symmetrical involving the medial and posterior aspect of both thalami displaying bright signal in DWI, T2 and FLAIR.
Previous gastric sugery or Bariatric sugeries are predisposing factors to various deficiency syndromes. Thiamine deficiency causes acute encephalopathy usually affects the medial thalamus, tectal plate and periacqueductal grey matter.
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