PMC9876722_01
Head computed tomography conducted on day 108. Computed tomography revealed areas with decreased density, especially in the bilateral basal ganglia.
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Head computed tomography showed bilateral decreased intensity lesions in the basal ganglia (Fig. 1), and the patient was referred to our department.
Initial magnetic resonance imaging conducted on day 108. Diffusion-weighted imaging revealed high signal intensities in the bilateral striatum, which showed a decreased apparent diffusion coefficient, suggesting cytotoxic edema. Fluid-attenuated inversion recovery images and T2-weighted imaging revealed hyperintensities in the bilateral striatum and mamillary bodies (arrow).
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On fluid-attenuated inversion recovery (FLAIR) images and T2-weighted imaging (T2WI), hyperintensities were seen in the bilateral striatum and mamillary bodies (Fig. 2).
Follow-up magnetic resonance imaging conducted on day 112. Diffusion-weighted imaging revealed a hyperintense lesion in the left frontal cortex, and fluid-attenuated inversion recovery imaging also revealed hyperintensity. Fluid-attenuated inversion recovery and T2-weighted imaging showed swelling of the caudate head. These lesions are depicted as areas of increased signal intensity on diffusion-weighted imaging and iso-intensity on apparent diffusion coefficient-suspected vasogenic edema.
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T2WI showed swelling of the caudate head. These lesions were depicted as having an increased signal intensity on DWI and iso-intensity on ADC-suspected vasogenic edema (Fig. 3).
Follow-up magnetic resonance imaging conducted on day 151. Faintly hyperintense lesions remained in the basal ganglia on fluid-attenuated inversion recovery imaging and T2- and T1-weighted imaging. HD: hemodialysis, mPSL: methylprednisolone, PSL: prednisolone
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Follow-up MRI conducted on day 151 revealed faintly hyperintense lesions in the basal ganglia on FLAIR, T2WI, and T1WI (Fig. 4).
Clinical course of the patient, a 30-year-old man with Wernicke encephalopathy. Most of his symptoms gradually improved with thiamine supplementation, but memory disturbance remained.
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He was transferred to another hospital for rehabilitation on day 156 (Fig. 5).