Sparacia G, Banco A, Lagalla R
Institute of Radiology "P. Cignolini", University of Palermo, Via del Vespro, 127, I-90 127 Palermo, Italy.
Pediatr Radiol. 1999 Aug;29(8):581-4. doi: 10.1007/s002470050652.
We report an unusual paediatric presentation of acute Wernicke's encephalopathy in a 12-year-old boy affected by chronic gastrointestinal disease. MRI demonstrated, in addition to the typical diencephalic and mesencephalic signal abnormalities on T2-weighted images, enhancement of the mammillary bodies and the floor of the hypothalamus.
Following parenteral administration of thiamine for 4 days, the patient recovered from his neurological deficits and on follow-up enhanced MRI 1 month later, no signal abnormalities were found nor was there diencephalic or mesencephalic atrophy, as is usual in the chronic phase of the disease.
MRI provides crucial information in the diagnosis of Wernicke's encephalopathy, either in the acute or chronic phases of the disease.
Our report provides an additional clue for recognition of the acute phase of the disease; enhancement of the floor of the hypothalamus has not previously been described despite its recorded involvement at autopsy.
我们报告了一名12岁患慢性胃肠疾病男孩急性韦尼克脑病的不寻常儿科表现。MRI显示，除了在T2加权图像上典型的间脑和中脑信号异常外，乳头体和下丘脑底部有强化。
经肠胃外给予硫胺素4天后，患者的神经功能缺损症状恢复，1个月后进行的增强MRI随访显示，未发现信号异常，也没有间脑或中脑萎缩，而这在该疾病的慢性期通常会出现。
MRI在韦尼克脑病的急性期或慢性期诊断中都提供了关键信息。
我们的报告为识别该疾病的急性期提供了额外线索；尽管尸检记录显示下丘脑底部受累，但此前尚未有关于其强化的描述。
