Investig Magn Reson Imaging.  2016 Mar;20(1):71-74. 10.13104/imri.2016.20.1.71.

Wernicke's Encephalopathy with Intracranial Hemorrhage

• Jeon S
• Kang H

• KMID: 2161373
• DOI: http://doi.org/10.13104/imri.2016.20.1.71

Abstract

Wernicke's encephalopathy (WE) is an acute neurological disorder resulting from thiamine deficiency. Early diagnosis and treatment of WE is important to avoid persistent brain damage. Although histopathologic examination usually demonstrates pin-point hemorrhages in affected brain parenchyma, secondary hemorrhage is a rare but serious complication of WE. We experienced a rare case of intracranial hemorrhage related to WE in a 56-year-old male patient with malnourishment.

Keyword

Wernicke's encephalopathy; Intracranial hemorrhage; Magnetic resonance imaging

MeSH Terms

Brain
Early Diagnosis
Hemorrhage
Humans
Intracranial Hemorrhages*
Magnetic Resonance Imaging
Male
Middle Aged
Nervous System Diseases
Thiamine Deficiency
Wernicke Encephalopathy*

Figure

• 

  Fig. 1 A 56-year-old male patient with malnourishment. (a-d) These images show bilaterally, symmetrically high signal lesions in the mammillary bodies, tectal plate, hypothalami, both medial thalamic nuclei, periaqueductal gray matter, and dorsal upper medulla on DWI and low signals on ADC map in the corresponding areas. (e-h) On FLAIR images of the brain, high signal lesions are seen in the mammillary bodies, tectal plate, hypothalami, both medial thalamic nuclei, periaqueductal gray matter, and dorsal upper medulla. (i) On MR spectroscopy, there is decreased NAA peak level in the medial thalamic nuclei which suggests that brain lesions were results from neuronal injury. (j) On brain CT, there are newly developed intracerebral hemorrhage in the thalamus and periaqueductal gray matter and intraventricular hemorrhage in the both lateral, third, and fourth ventricles.

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