Reversible hepatocerebral degeneration-like syndrome due to portovenous shunts
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Ataxia and tremor are rare manifestations of hepatocerebral degeneration due to portovenous shunts. Ammonia is a neurotoxin that plays a significant role in the pathogenesis of hepatic encephalopathy. A 58-year old male patient was assessed with the complaints of gait disturbance, hand tremor, and impairment of speech. His neurological examination revealed dysarthric speech and ataxic gait. Bilateral kinetic tremor was noted, and deep tendon reflexes of the patient were hyperactive. Serum ammonia level was found to be 156.9 ?g/dL. Cranial magnetic resonance (MR) imaging revealed increased signal intensity in bilateral globus pallidus on T1-weighted axial sections, and bilateral prominent hyperintense lesions in the middle cerebellar peduncles on T2-weighted axial sections. On his abdominal MR portography, multiple portohepatic venous collaterals were noted in the right and left lobes of liver parenchyma in 2D FIESTA axial MR sections. To our knowledge, we reported the first case of acquired hepatocerebral degeneration presenting with cerebral symptoms without any hepatic findings in which clinical improvement was noted, and hyperammonemia disappeared following medical treatment.
Açıklama
Anahtar Kelimeler
Hepatocerebral Degeneration; Portovenous Shunt; Prognosis; Treatment, Adult; Article; Blood Vessel Shunt; Case Report; Dysarthria; Echography; Flapping Tremor; Gait Disorder; Gastrointestinal Endoscopy; Hand Tremor; Human; Hypotension; Liver Function Test; Male; Middle Aged; Middle Cerebellar Peduncle; Neurologic Examination; Nuclear Magnetic Resonance Imaging; Portal Phlebography; Portovenous Shunt; Speech Disorder; Tendon Reflex; Unconsciousness; Wilson Disease; Arteriovenous Fistula; Ataxia; Brain; Cerebellum; Dysarthria; Globus Pallidus; Hepatolenticular Degeneration; Humans; Hyperammonemia; Magnetic Resonance Imaging; Male; Middle Aged; Portal Vein; Syndrome; Treatment Outcome; Tremor
Kaynak
Ideggyogyaszati Szemle
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
66
Sayı
11.Ara
