Yahya ÇELİK, Bahar ÖZBEK, MUSTAFA KEMAL BALCI, Ercüment ÜNLÜ, Ufuk UTKU

Hepatik ensefalopati ve MR görüntülemede atipik kortikal tutulum: Olgu sunumu

Hepatik ensefalopati karaciğer fonksiyon bozukluğuna bağlı olarak hastalarda nöropsikiyatrik belirtilerin gelişimi ile karakterizedir. Siroz, portal hipertansiyon veya porto-sistemik şantlar ve akut karaciğer yetmezliği durumlarında gelişebilir. Hafif mental durum bozukluklarından derin komaya kadar değişen geniş bir klinik tablo ile ortaya çıkabilir. Manyetik rezonans görüntüleme (MRG) başta olmak üzere nöro-görüntüleme teknikleri hepatik ensefalopati tanısında kullanılabilir. Sağlıklı bireylerde kolayca metabolize edilebilen maddelerin birikimine bağlı olarak özellikle T1 ağırlıklı MRG'de iki yanlı globus pallidus yapılarında sinyal artışı izlenir. Hepatik ensefalopatide kortikal tutulum oldukça nadir bildirilmiştir. Bu yazıda kortikal ve subkortikal yapıların tutulumu ile seyreden bir hepatik ensefalopati olgusu sunulmuştur.

Anahtar Kelimeler:

Nöropsikolojik testler, Erkek, Hepatik ensefalopati, Manyetik rezonans görüntüleme, Orta yaşlı

Hepatic encephalopathy and atypical cortical involvement in cranial MRI: Case report

Hepatic encephalopathy is characterized by neuropsychiatric abnormalities occurring in patients with liver dysfunction. It most commonly occurs in association with cirrhosis, portal hypertension, portal-systemic shunts and acute liver failure. Clinical features of hepatic encephalopathy varies between mild cognitive impairment to deep coma. Several neuroimaging techniques, especially magnetic resonance imaging (MRI), may eventually be useful for the diagnosis of hepatic encephalopathy. Cranial MRI may demonstrate high signal intensity in the bilateral globus pallidum on T1-weighted images. Cortical involvement due to hepatic encephalopathy is rarely reported in the literature. We presented here a case of hepatic encephalopathy with cortical and subcortical involvement.

Keywords:

Neuropsychological Tests, Male, Hepatic Encephalopathy, Magnetic Resonance Imaging, Middle Aged,

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