Reversible posterior leukoencephalopathy syndrome in a patient with severe uremic encephalopathy

Clin Nephrol. 2010 Aug;74(2):154-8. doi: 10.5414/cnp74154.

Abstract

A 59-year-old male presented at our hospital with disturbance of consciousness. He had severe neurological disturbances associated with uremia caused by severe renal insufficiency. Cranial computed tomography (CT) was normal on admission. FLAIR-weighted MRI showed increased signal intensities bilaterally in the cortical and subcortical areas of the occipital lobe. Repeated hemodialysis resulted in improvement of the clinical symptoms and blood chemistry, and normalization of the MRI findings. Although the patient was discharged without neurological deficit, he had to be maintained on regular intermittent hemodialysis due to persistent renal failure. These reversible neuroradiological abnormalities may have been caused by reversible brain edema, but other pathoetiological factors should be also considered, such as abnormalities of cerebral metabolism and effects of uremic toxins.

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases, Metabolic / diagnosis
  • Brain Diseases, Metabolic / etiology*
  • Brain Diseases, Metabolic / therapy
  • Brain Edema / diagnosis
  • Brain Edema / etiology*
  • Brain Edema / therapy
  • Humans
  • Hypertensive Encephalopathy / complications*
  • Hypertensive Encephalopathy / diagnosis
  • Hypertensive Encephalopathy / therapy
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Renal Dialysis
  • Syndrome
  • Tomography, X-Ray Computed
  • Uremia / complications*
  • Uremia / diagnosis
  • Uremia / therapy