Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report
Hepatic encephalopathy may trigger cortical laminar necrosis (CLN), which is characterized by diffuse symmetric cortical lesions. We report a 56-year-old woman with liver cirrhosis who presented with prolonged floor station, reduced alertness and left hemiplegia. Blood ammonia level was elevated. Ma...
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Elsevier
2025-03-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324013499 |
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| author | Inas AL CHARE Mickaël BONNAN |
| author_facet | Inas AL CHARE Mickaël BONNAN |
| author_sort | Inas AL CHARE |
| collection | DOAJ |
| description | Hepatic encephalopathy may trigger cortical laminar necrosis (CLN), which is characterized by diffuse symmetric cortical lesions. We report a 56-year-old woman with liver cirrhosis who presented with prolonged floor station, reduced alertness and left hemiplegia. Blood ammonia level was elevated. Magnetic resonance imaging showed acute left cerebellar infarction, diffuse cortical lesions mostly involving the right temporo-fronto-parietal cortex with restricted diffusion, and right subarachnoid hemorrhage. This case of CLN lesions related to hepatic encephalopathy is characterized by unique pattern of almost unilateral lesions. We hypothesize that the right predominance of the brain cortical lesions could be a consequence of synergistic factors associating subarachnoid hemorrhage in the setting of hepatic encephalopathy. This finding refines the pathophysiology of metabolic CLN. |
| format | Article |
| id | doaj-art-7970c724fcec471b982ff5db988bed44 |
| institution | Kabale University |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-7970c724fcec471b982ff5db988bed442025-01-18T05:04:01ZengElsevierRadiology Case Reports1930-04332025-03-0120313891392Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case reportInas AL CHARE0Mickaël BONNAN1Corresponding author.; Department of Neurology, Delafontaine Hospital, Seine Saint-Denis, FranceDepartment of Neurology, Delafontaine Hospital, Seine Saint-Denis, FranceHepatic encephalopathy may trigger cortical laminar necrosis (CLN), which is characterized by diffuse symmetric cortical lesions. We report a 56-year-old woman with liver cirrhosis who presented with prolonged floor station, reduced alertness and left hemiplegia. Blood ammonia level was elevated. Magnetic resonance imaging showed acute left cerebellar infarction, diffuse cortical lesions mostly involving the right temporo-fronto-parietal cortex with restricted diffusion, and right subarachnoid hemorrhage. This case of CLN lesions related to hepatic encephalopathy is characterized by unique pattern of almost unilateral lesions. We hypothesize that the right predominance of the brain cortical lesions could be a consequence of synergistic factors associating subarachnoid hemorrhage in the setting of hepatic encephalopathy. This finding refines the pathophysiology of metabolic CLN.http://www.sciencedirect.com/science/article/pii/S1930043324013499Cortical laminar necrosisHepatic encephalopathySubarachnoid hemorrhageCase report |
| spellingShingle | Inas AL CHARE Mickaël BONNAN Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report Radiology Case Reports Cortical laminar necrosis Hepatic encephalopathy Subarachnoid hemorrhage Case report |
| title | Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report |
| title_full | Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report |
| title_fullStr | Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report |
| title_full_unstemmed | Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report |
| title_short | Cortical laminar necrosis triggered by hepatic encephalopathy and post-traumatic subarachnoid hemorrhage: Case report |
| title_sort | cortical laminar necrosis triggered by hepatic encephalopathy and post traumatic subarachnoid hemorrhage case report |
| topic | Cortical laminar necrosis Hepatic encephalopathy Subarachnoid hemorrhage Case report |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324013499 |
| work_keys_str_mv | AT inasalchare corticallaminarnecrosistriggeredbyhepaticencephalopathyandposttraumaticsubarachnoidhemorrhagecasereport AT mickaelbonnan corticallaminarnecrosistriggeredbyhepaticencephalopathyandposttraumaticsubarachnoidhemorrhagecasereport |