Tokue Hiroyuki, Ishikawa Rei, Oshima Kiyohiro, Sawada Yusuke, Aramaki Yuto, Kawano Kei, Nihei Takumi, Isogai Kouta, Kawahara Kohei, Yokota Takayuki, Yasui Hiroyuki, Ikeya Miho, Okabe Tamaki, Tokue Azusa, Tsushima Yoshito
Department of Diagnostic and Interventional Radiology, Gunma University Hospital, Gunma, Japan.
Department of Emergency Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.
Radiol Case Rep. 2024 Feb 13;19(5):1729-1733. doi: 10.1016/j.radcr.2024.01.063. eCollection 2024 May.
This case report highlights the rare occurrence of Wernicke encephalopathy caused by malnutrition in a depressed patient with atypical imaging findings. A 60-year-old female with depression developed a disturbance of consciousness owing to Wernicke encephalopathy. Magnetic resonance imaging showed abnormal signals in the thalamus and mammillary bodies around the third ventricle, cerebral aqueduct, and fourth ventricle. Abnormal signals were also present in the cerebral cortex around the central sulcus, and an intracranial hemorrhage from the thalamus was observed. Therefore, clinicians should consider Wernicke encephalopathy in the differential diagnosis of altered consciousness in depressed patients. Early assessment of nutritional status and prompt intervention are crucial in cases of prolonged depression-related malnutrition.
本病例报告强调了在一名患有非典型影像学表现的抑郁症患者中，由营养不良引起的韦尼克脑病的罕见发生情况。一名60岁的抑郁症女性因韦尼克脑病出现意识障碍。磁共振成像显示第三脑室周围的丘脑和乳头体、中脑导水管及第四脑室有异常信号。中央沟周围的大脑皮质也有异常信号，并且观察到丘脑有颅内出血。因此，临床医生在抑郁症患者意识改变的鉴别诊断中应考虑韦尼克脑病。对于长期与抑郁症相关的营养不良病例，早期评估营养状况并及时干预至关重要。
