Document Detail

Portal systemic encephalopathy presenting with dressing and constructional apraxia.
MedLine Citation:
PMID:  10830187     Owner:  NLM     Status:  MEDLINE    
We report a case with portal systemic encephalopathy who presented with dressing and constructional apraxia and subtle weakness of the left hand. We initially suspected a cerebrovascular attack in the right cerebral hemisphere, but brain T1-weighted magnetic resonance (MR) imaging revealed high intensity in the basal ganglia and hyperammonemia was detected. We performed abdominal MR angiography, which visualized an intrahepatic portal systemic shunt. Cerebral blood flow, measured by xenon-enhanced computed tomography, was decreased in the bilateral, but more dominantly right-sided, parietal watershed regions. We speculate that these boundary territories might be susceptible to damage by toxic metabolites of hepatic encephalopathy.
T Kanda; S Nogawa; K Muramatsu; A Koto; Y Fukuuchi
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  39     ISSN:  0918-2918     ISO Abbreviation:  Intern. Med.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-09-18     Completed Date:  2000-09-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  419-23     Citation Subset:  IM    
Department of Neurology, Keio University, Tokyo.
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MeSH Terms
Apraxias / diagnosis,  etiology*
Hepatic Encephalopathy / diagnosis*,  physiopathology,  psychology
Magnetic Resonance Angiography
Magnetic Resonance Imaging

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