FINDINGS Figure 227-1. Axial FLAIR through the temporal lobes. There is bilateral symmetrical mesiotemporal lobe hyperintensity (arrows). Figure 227-2. Axial FLAIR through the sylvian fissures. There is bilateral symmetrical insular cortex hyperintensity (arrows). Figure 227-3. Axial T1WI through the basal ganglia. There is bilateral globus pallidus hyperintensity (arrows) often seen in chronic hepatic encephalopathy (HE).
DIFFERENTIAL DIAGNOSIS Hypoxic-ischemic encephalopathy, Wilson disease, cholestatic disorders, parenteral hyperalimentation, viral encephalitis, and sporadic Creutzfeldt-Jacob disease (CJD), HE.
DIAGNOSIS HE.
DISCUSSION
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