Presentation
Altered sensorium with AKI (Acute kidney injury, elevated creatinine level).
Patient Data
There is an abnormal signal alteration in the bilateral medial temporal lobes, hippocampi, insular lobes, parasagittal frontoparietal lobes and right basal ganglia region. These area appears T2W/FLAIR hyperintense with patchy areas of diffusion restriction on DWI. No evidence of hemorrhage was seen within it. There is near complete compression effacement of the right lateral ventricle's frontal horn by the caudate lobe's involvement.
Case Discussion
The above MRI features are likely due to uremic encephalopathy in a given clinical history of acute kidney injury. CSF study was normal. The differential diagnosis includes other metabolic encephalopathy and herpes encephalitis, however, in herpes encephalitis basal ganglia are usually spared.
Co-author: Dr. Sanaullah mudassir (DM, Neuro medicine).
Unable to process the form. Check for errors and try again.