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Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

27
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
27
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

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Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
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Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

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A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial...
47
Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

34
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
34
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

31
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
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Hepatic Encephalopathy01:29

Hepatic Encephalopathy

71
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic...
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Lipidomics and Transcriptomics in Neurological Diseases
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Hidden Encephalopathy: A Mysterious Case.

Raquel Dias Moura1, Mariana Estrela Santos1, Francisca Carmo1

  • 1Internal Medicine, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, PRT.

Cureus
|March 10, 2025
PubMed
Summary
This summary is machine-generated.

A 62-year-old woman with cholangiocarcinoma developed hepatic encephalopathy (HE) type B due to an unusual liver condition. This case emphasizes careful patient history and examination for diagnosing neurological changes.

Keywords:
ammoniahepatic encephalopathyportal vein arterializationportosystemic shunttype b hepatic encephalopathy

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Area of Science:

  • Neurology
  • Hepatology
  • Gastroenterology

Background:

  • Hepatic encephalopathy (HE) is a spectrum of neuropsychiatric abnormalities caused by liver dysfunction.
  • Cirrhosis is the most common cause, but HE can occur in other conditions.
  • Ammonia accumulation due to impaired liver detoxification is a key pathogenic factor.

Observation:

  • A 62-year-old woman with treated cholangiocarcinoma presented with acute confusion and neurological deficits.
  • Initial labs showed normal liver function but elevated ammonia; no infection was found.
  • Her history revealed a rare portal "arterialization" via hepatic artery-portal vein anastomosis.

Findings:

  • The patient was diagnosed with hepatic encephalopathy type B.
  • This specific type of HE was linked to the unique vascular anomaly in her liver.

Implications:

  • This case underscores the critical role of detailed medical history and physical examination in diagnosing HE.
  • Recognizing uncommon causes like portal "arterialization" is vital for accurate HE diagnosis and management.
  • Acute neurological changes in patients with complex histories necessitate a comprehensive diagnostic approach.