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Type:
Educational Exhibit
Keywords:
Neuroradiology brain, CNS, MR, MR-Diffusion/Perfusion, Imaging sequences, Acute, Metabolic disorders, Toxicity
Authors:
S. Sood, R. Gupta, J. Sharma, J. Modi; Gurgaon/IN
DOI:
10.1594/ecr2014/C-0492
Background
Acute toxic-metabolic encephalopathy is an acute condition of global cerebral dysfunction encompassing delirium and the acute confusional state in the absence of primary structural brain disease.
Toxic and metabolic encephalopathies are common among critically ill patients and usually present with seizures and focal neurological deficits.
A large number of conditions can present with similar clinical condition and MRI can help narrow the differential diagnosis.
Also,
in a patient with known exposure to a toxic agent,
topographic distribution of the lesions can help exclude other causes of neurologic impairment.
In general,
toxic and acquired metabolic disorders produce a widespread,
symmetric pattern of injury that often involves the deep gray nuclei and cerebral cortex.
Myelin,
with its high lipid content is particularly vulnerable to lipophilic toxic substances.
Key Points
- Toxic and metabolic encephalopathies are common among critically ill patients and usually present with seizures and focal neurological deficits.
- Widespread symmetric pattern of injury that often involves the deep gray nuclei and cerebral cortex is seen.
- Topographic distribution of the lesions can help exclude other causes of neurologic impairment.
Myelin,
with its high lipid content is particularly vulnerable to lipophilic toxic substances.