EURORAD ESR

Case 15555

Reversible posterior encephalopathy and cerebral vasoconstriction in acute intermittent porphyria

Author(s)
Alja Longo, Jernej Avsenik

Neuroradiology Department, Clinical Institute of Radiology, University Medical Centre Ljubljana, Slovenia
 
Patient
female, 31 year(s)
 
 
  • Figure 1
    Head CT after seizures and resuscitation

    Head CT showed an small subcortical hypodensity in the left frontal lobe.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Comparative studies; Special Focus: Acute;
     
     
  • Figure 2
    Initial brain MRI

    Relatively symmetric signal changes, located cortically and subcortically in both posterior parietal lobes with mild effacement of adjacent sulci were seen on FLAIR images.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Comparative studies; Special Focus: Oedema;
     
     
  • Figure 3
    Initial TOF MRA

    TOF MRA images showed segmental narrowing of intracranial arteries, which was most pronounced in the posterior circulation.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Comparative studies; Special Focus: Pathology;
     
     
  • Figure 4
    Control brain MRI

    MRI after 2 weeks showed disappearance of signal changes in posterior parietal lobes on FLAIR images. Sulci appeared normal.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Comparative studies; Special Focus: Oedema;
     
     
  • Figure 5
    Control TOF MRA

    TOF MRA images after 2 weeks showed marked improvement of segmental narrowing of cerebral arteries.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Angiography; Procedure: Comparative studies; Special Focus: Metabolic disorders;
     
     
Head CT showed an small subcortical hypodensity in the left frontal lobe.
 
Relatively symmetric signal changes, located cortically and subcortically in both posterior parietal lobes with mild effacement of adjacent sulci were seen on FLAIR images.
 
TOF MRA images showed segmental narrowing of intracranial arteries, which was most pronounced in the posterior circulation.
 
MRI after 2 weeks showed disappearance of signal changes in posterior parietal lobes on FLAIR images. Sulci appeared normal.
 
TOF MRA images after 2 weeks showed marked improvement of segmental narrowing of cerebral arteries.
 
 
 
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