The main learning objectives of this exhibit are:
To review the main imaging patterns of central nervous system (CNS) injury occurring in the setting of acquired metabolic and hydroelectrolytic disorders.
To illustrate the imaging spectrum of these pathologies,
primarily by magnetic resonance imaging (MRI) but also by computer tomography (CT)
As in diseases due to inborn errors of metabolism,
CNS may be injured during acquired metabolic and ionic disturbances.
Acquired metabolic disorders can occur in both adults and children,
in relation nutritional deficiencies,
abnormalities of glucose and electrolyte levels and impaired organ function.
Specific toxins tend to affect specific regions of the CNS selectively,
providing recognizable patterns radiologists should be familiar with.
Findings and procedure details
1 – Hypoglycemia
- Neonatal hypoglycemia (<46 mg/dL) occurs in 5%-15% of normal term neonates and can cause visual impairment,
and cognitive deficits.
- Most common metabolic imbalance of the newborn.
- In the adults is usually related to overmedication with oral antidiabetic drugs.
Typical location of lesions: Bilateral occipital/parietal lobes (cortex and white matter)
Also documented by imaging and/or pathology
acquired metabolic and hydroelectrolytic disorders preferentially originate lesion in the deep gray matter,
with less frequent involvement of white matter and cortex; they are typically bilateral and symmetrical,
with the exception of nonketotic hyperglycemia,
which is usually unilateral.
Although imaging patterns are not totally specific,
imaging studies and mainly MRI can show suggestive lesions.
Most typical location of lesions and atypical or less frequent...
MR Findings in Kernicterus,
AJNR 1995; 16:819-821
Kumandas S et al,
Hyperintense globus Pallidus on T1-weighted MR imaging in acute Kernicterus: is it common or rare?,
Eur Radiol 2005; 15:1263–1267
Brain Injury Patterns in Hypoglycemia in Neonatal Encephalopathy,
AJNR Am J Neuroradiol 2013;
Imaging patterns of neonatal...