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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
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Hepatic encephalopathy with corticospinal tract involvement demonstrated by diffusion tensor tractography
Hyun Bang1, Hye Yeon Lee1, Bo-Ram Kim1
1Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea.
Annals of Rehabilitation Medicine
|March 10, 2015
Summary
This case study highlights hepatic encephalopathy affecting the corticospinal tract in a patient with liver cirrhosis. Diffusion tensor tractography revealed damage to the right corticospinal tract, explaining persistent neurological deficits.
Area of Science:
- Neurology
- Hepatology
- Radiology
Background:
- Liver cirrhosis can lead to hepatic encephalopathy (HE), a neuropsychiatric complication.
- HE typically presents with altered mental status, but focal neurological deficits can occur.
Purpose of the Study:
- To report a case of hepatic encephalopathy with corticospinal tract involvement.
- To illustrate the utility of diffusion tensor tractography (DTT) in visualizing HE-related neurological damage.
Main Methods:
- Case presentation of a 50-year-old man with liver cirrhosis and recurrent esophageal variceal bleeding.
- Magnetic resonance imaging (MRI) to assess brain lesions.
- Diffusion tensor tractography (DTT) to evaluate white matter tracts.
Main Results:
- The patient presented with drowsiness, left hemiparesis, and elevated serum ammonia levels.
- MRI revealed characteristic changes of hepatic encephalopathy in the cerebral cortex.
- DTT demonstrated decreased volume of the right corticospinal tract, correlating with persistent left-sided weakness.
Conclusions:
- Hepatic encephalopathy can manifest with corticospinal tract injury, leading to persistent motor deficits.
- DTT is a valuable tool for detecting and characterizing HE-induced white matter abnormalities.
- This case underscores the complex neurological sequelae of advanced liver disease.
