Abstract
A 34-year-old woman suffering from renal dysfunction for several years was admitted to our hospital because of an exacerbation. Neurological findings suggested that she was suffering from uremic encephalopathy (UE). After hemodialysis, her neurological findings improved remarkably. Brain magnetic resonance imaging (MRI) and computed tomography (CT) were performed before and after hemodialysis. Before treatment, the T2-weighted MRI image revealed high intensity and the T1-weighted image showed strong low intensity bilaterally around the globus pallidus, internal capsule, and corona radiata. Low density was observed in the same areas on a CT scan. The T2-weighted MRI image alone also showed abnormally high intensity in the brain stem area. After the 4th hemodialysis, abnormal MRI and CT images were still observed, but the intensity of abnormalities had decreased and the patient showed improvement in her neurological symptoms. After the 16th hemodialysis, the abnormal images disappeared on both the MRI and CT scans. Although the detailed pathophysiology of UE is still unknown, the MRI and clinical changes observed in this patient suggest that diffuse edematous brain damage is one of the characteristic features of UE.
