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Case No. 761
2026-08-01~2026-08-31
출제자 : 전영훈
Hit : 304
| Period | 2026-08-01~2026-08-31 |
|---|---|
| Diagnosis | Wernicke’s encephalopathy |
| Gender |
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| Age | 63 |
| Clinical information | 63-year-old woman who presented with double vision and confusion that began three days ago. What is the diagnosis? |
| Discussion | Acute neurologic disorder caused by thiamine deficiency Triad: ophthalmoplegia, ataxia, and confusion (about 10-20% of patients show all three signs) Imaging findings Bilateral symmetric T2/FLAIR hyperintensity: medial thalami, mamillary bodies, tectal plate, and periaqueductal area Atypical involvement: cerebral cortex, cranial nerve nuclei, red nuclei, caudate nuclei, and splenium Mammillary body enhancement Diffusion restriction in the acute phase ASL perfusion: focal hyperperfusion in the characteristically involved regions Refrernce Ko SB, Kim TJ, Sohn CH. Focal hyperemia in Wernicke's encephalopathy: a preliminary arterial spin labeling MRI study. Neuroradiology. 2020 Jan;62(1):105-108. |
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