Doctor's Information

Name :   Hamid Reza
Family : Haghighatkhah 
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :   Masoome Raoufi

Patient's Information

Gender :   Male
Age :   50

Case Section

Head & Neck Imaging

Clinical Summary

50 Y/O man,altered mental status.

Images

Imaging Procedures and Findings

MR demonstrates abnormal high signal on T2WI and low signal on T1, corresponding to the regions of central pontine demyelination. Additionally, extrapontine site of involvement has seen in white matter of thalamus.CT scan show central pontin radioluency.

Discussion

Central pontine myelinolysis (CPM) is a disorder that results in characteristic demyelination of the central pons. This is most commonly seen in patients with electrolyte abnormalities, particularly involving hyponatremia.Occasionally, cases have been associated with diabetes, leukemia, transplant recipients, chronically debilitated patients, and others with conditions resulting in chronic malnutrition. MR characteristically demonstrates abnormal high signal on T2WI, corresponding to the regions of central pontine demyelination .Additionally, extrapontine sites of involvement have been described in this condition, including the white matter of the cerebellum, thalamus, globus pallidus, putamen, and lateral geniculate body, giving rise to the term extrapontine myelinolysis

Final Diagnosis

Central pontine myelinolysis (CPM)

References

Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd edition. P196-198.

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