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Published on: October 28, 2022
Potentially Reversible and Recognizable Acute Encephalopathic Syndromes: Disease Categorization and MRI Appearances
1From the Department of Radiology (Y.K.), Division of Neuroradiology, University of Minnesota Medical Center, Minneapolis, Minnesota ykksel@umn.edu.
Abstract:
"Encephalopathy" is a vague term that encompasses varying definitions, often with a nonspecific clinical presentation and numerous possible pathophysiologic causes. Hence, MR imaging plays a crucial role in the early diagnosis and treatment by identifying imaging patterns when there is limited clinical history in such patients with acute encephalopathy. The aim of this review was to aid in remembrance of etiologies of potentially reversible acute encephalopathic syndromes on MR imaging. The differential includes vascular (reversible cerebral vasoconstriction syndrome, transient global amnesia, disseminated intravascular coagulation, and thrombotic microangiopathy), infection (meningitis, encephalitis), toxic (posterior reversible encephalopathy syndrome, acute toxic leukoencephalopathy; carbon monoxide, alcohol-related, medication- and illicit drug-related toxic encephalopathies), autoimmune, metabolic (osmotic demyelination syndrome, uremic, acute hepatic encephalopathy), idiopathic/inflammatory (stroke-like migraine attacks after radiation therapy syndrome), neoplasm-related encephalopathy, and seizure-related encephalopathy.
Insights
Magnetic resonance (MR) imaging aids in diagnosing acute encephalopathy by identifying patterns, especially with limited clinical history. This review highlights key MR imaging findings for various reversible encephalopathic syndromes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Encephalopathy is a broad term with nonspecific clinical presentations and diverse causes.
- Early diagnosis and treatment of acute encephalopathy are critical, often relying on imaging when clinical information is scarce.
Purpose of the Study:
- To review and summarize the magnetic resonance (MR) imaging findings of potentially reversible acute encephalopathic syndromes.
- To assist clinicians in recognizing characteristic MR imaging patterns associated with various encephalopathies.
Main Methods:
- Review of literature focusing on MR imaging characteristics of acute encephalopathic conditions.
- Categorization of encephalopathies based on underlying pathophysiology (vascular, infectious, toxic, autoimmune, metabolic, etc.).
Main Results:
- Detailed description of MR imaging patterns for specific reversible encephalopathies.
- Differential diagnosis of acute encephalopathy based on characteristic imaging findings.
Conclusions:
- MR imaging is indispensable for the early diagnosis and management of acute encephalopathy.
- Familiarity with MR imaging patterns aids in identifying potentially reversible causes of encephalopathy.
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