Acute hepatic encephalopathy with diffuse cortical lesions

Neuroradiology. 2001 Jul;43(7):551-4. doi: 10.1007/s002340000461.


Acute hepatic encephalopathy is a poorly defined syndrome of heterogeneous aetiology. We report a 49-year-old woman with alcoholic cirrhosis and hereditary haemorrhagic telangiectasia who developed acute hepatic coma induced by severe gastrointestinal bleeding. Laboratory analysis revealed excessively elevated blood ammonia. MRI showed lesions compatible with chronic hepatic encephalopathy and widespread cortical signal change sparing the perirolandic and occipital cortex. The cortical lesions resembled those of hypoxic brain damage and were interpreted as acute toxic cortical laminar necrosis.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Brain / pathology
  • Female
  • Hepatic Encephalopathy / etiology*
  • Hepatic Encephalopathy / pathology*
  • Humans
  • Hypoxia-Ischemia, Brain / diagnosis
  • Hypoxia-Ischemia, Brain / pathology
  • Liver Cirrhosis, Alcoholic / complications*
  • Liver Cirrhosis, Alcoholic / pathology
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Necrosis