*60-year-old patient with chronic liver failure.
What is the most likely diagnosis?
Answer
Answer:
Hepatic encephalopathy
Case Discussion:
T1-weighted MR images of brain revealed the bilateral and symmetric high T1 signal-intensity change involving the globus pallidus and the anterior midbrain. CT images of abdomen showed the nodular hepatic surface and coronary-paraesophageal serpiginous tubular structures consistent with varices.
Hepatic encephalopathy, also known as portosystemic encephalopathy, refers to an encephalopathy occurring in patients with acute liver failure, a portosystemic shunt, or chronic liver disease. Hepatic encephalopathy results from exposure of the brain to excessive amounts of ammonia.
References:
1. Leonard JR, Moran CJ, Cross DT et-al. MR imaging of herpes simplex type 1 encephalitis in infants and young children: a separate pattern of findings. AJR Am J Roentgenol. 2000;174 (6): 1651-5.