In the large sea of metabolic disorders and toxic substances that can cause brain damages, this poster will not make just a “list of noxae and their lesions”. It wants to provide not only a "topographic approach" to the analysis of toxic and metabolic encephalopathies, but also it proposes to: Understand the reasons why a particular brain area is affected Understand the meaning behind different signal features (e.g. different cerebral edema, deposits) Identify some related reactive conditions: Posterior-reversible-encephalopathy-syndrome (PRES), Reversible-cerebral-vasoconstriction-syndrome (RCVS)

The brain represents only 2% of body weight, but it consumes about 20% of blood oxygen and 25% of glucose. Due to its high metabolic demands the brain is very vulnerable to toxic substances or metabolic disorders. Toxic\metabolic encephalopathies commonly present a symmetrical brain involvement, they mainly affect the basal ganglia (BG), the white matter (WM), thalami and cortex(Tab.1). Gray matter (GM) is highly metabolically active; BG present rich vascularization, high levels of mitochondria and neurotransmitters, globi pallidi (GP) and putamen are particularly susceptible to...

Imaging plays a crucial role when patients with critical conditions arrive at the emergency department with an acute confusional state that can subtend a cerebral dysfunction. When clinical data suggest the presence of a toxic and\or metabolic disorder, many exogenous or endogenous causes and substances must be considered. A systematic approach based on the topographical distribution of imaging findings (patterns) and also on a specific signal appearance, is preferable to face this large group of diseases and it could suggest faster the most likely diagnosis...

Toxic and metabolic encephalopathies are relatively uncommon diseases, but if their cause is corrected or removed, they can be successfully treated, Patterns are not always pathognomonic, but each of them is related to a smaller number of differential diagnoses and they could be useful to recognize these entities faster, It's also important to identify acute situations from chronic diseases or deposits.

A. Marrazzo; Rome/IT - nothing to disclose A. Botto; Rome/IT - nothing to disclose P. Guadalupi; Rome/IT - nothing to disclose L. Milonia; Rome/IT - nothing to disclose F. Magnani; Rome/IT - nothing to disclose C. Giordano; Rome/IT - nothing to disclose T. Tartaglione; Rome/IT - nothing to disclose S. Gaudino; Rome/IT - nothing to disclose C. Colosimo; Rome/IT - nothing to disclose

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