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Case No. 654
2023-05-01~2023-05-31
출제자 : 이경미
Hit : 505
| Period | 2023-05-01~2023-05-31 |
|---|---|
| Diagnosis | Uremic Encephalopathy |
| Gender |
|
| Age | 49 |
| Clinical information | 49/F C.C> mental change Hx> Chronic kidney disease로 hemodialysis중 진단은? |
| Discussion | -Neurologic complication resulting from endogenous uremic toxins in patients with severe renal failure -Complex and unclear pathogenesis : local kidney injury may activate cytokines that cross BBB or activate other messengers that leads to neuronal dysfunction -Lethargy and confusion in acute phase, progress to seizure and/or coma in chronic phase CT -Confluent bilateral hypodensity involving BG, thalamus and midbrain -Anatomical boundaries b/w deep SCGM typically obliterated MR -Bilateral T2/FLAIR high SI involving BG, thalamus, midbrain, and mesial temporal lobes (vasogenic edema) -Diffusion restriction may be present to a varying degree (cytotoxic edema) -Lentiform fork sign : T2/FLAIR hyperintense WM surrounding BG (internal / external capsules and medullary laminae) |
| Correct answer |
Correct Answer
Semi-Correct Answer |