Document Detail

Reversible cytotoxic edema in a cirrhotic patient following TIPS.
MedLine Citation:
PMID:  19344367     Owner:  NLM     Status:  MEDLINE    
The authors report the magnetic resonance imaging (MRI) findings in a 52-year-old man with cirrhosis from chronic hepatitis C who developed episodic acute hepatic encephalopathy Type C following placement of transjugular intrahepatic portosystemic shunt (TIPS). Brain MRI revealed hyperintense T2 signal and restricted diffusion distributed through the cerebral cortex. The patient's mentation improved with treatment of his hyperammonemia. Brain MRI performed 5 months later revealed diffuse cerebral atrophy and new areas of hyperintense T2 signal in the cerebral white matter. The cortical signal abnormalities and low apparent diffusion coefficient values on the initial MRI resolved with exception of a mild amount of hyperintense FLAIR signal in the cingulate cortex. Acute hepatic encephalopathy following portosystemic shunting -- either from placement of TIPS or from development of spontaneous shunts -- is a widely recognized complication of portal hypertension and cirrhosis. We report MRI findings of reversible cytotoxic edema in a patient with acute hepatic encephalopathy following placement of TIPS.
James R Babington; Justin H Stahl; David L Coy
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-03-24
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  19     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-30     Completed Date:  2009-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  391-3     Citation Subset:  IM    
Department of Graduate Medical Education, Virginia Mason Medical Center, Seattle, WA 98111, USA.
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MeSH Terms
Brain / pathology*
Brain Edema / etiology*,  pathology*
Chronic Disease
Hepatitis C / complications
Liver Cirrhosis / etiology,  pathology*,  therapy
Magnetic Resonance Imaging
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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