MR Imaging of Central Pontine Myelinolysis

Rippe, David J.; Edwards, Mary K.; D’Amour, Peter G.; Holden, Robert W.; Roos, Karen L.

doi:10.1097/00004728-198707000-00037

Cited by 32 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The radiologic description of CPM entails the presence of "trident-shaped" symmetric hypointense lesions on T1 and corresponding hyperintense lesions on T2-weighted images located in the brain stem, and sparing of other brain regions. 42 In cases of EPM, the same features are noted typically in sites such as the internal capsule, basal ganglia, cerebellum, and cerebrum. 43 The neuroradiologic features of ODS lesions in the context of hyponatremia are frequently reported not to match the severity of clinical symptoms because the features might be absent despite clinical abnormalities or at times may persist well beyond clinical resolution.…”

Section: Osmotic Demyelination Syndromementioning

confidence: 91%

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Ismail¹,

Szóllics

Szólics

et al. 2013

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY:The complex interplay between hypernatremic osmotic disturbances and cerebral lesions is yet to be clarified. In this review, we discuss, on the basis of the reported data of hypernatremic CNS challenge in the adult population, the clinical and radiologic features of the condition. Our search captured 20 case studies and 1 case series with 30 patients in total who acquired acute hypernatremia due to different etiologies and developed CNS lesions. We explored the associations between premorbid conditions, clinical presentation, hypernatremic state, correction rate, and radiologic appearance, including the localization of brain lesions and the outcomes. The results revealed that altered mental status was the most commonly reported symptom and osmotic demyelination syndrome in the form of extrapontine myelinolysis was the prevailing radiologic pattern. Finally, we contrasted, when appropriate, clinical and experimental data related to hypernatremic and hyponatremic osmotic insults to aid the understanding of the pathophysiology of CNS osmotic brain injury.ABBREVIATIONS: BG ϭ basal ganglia; CPM ϭ central pontine myelinolysis; EPM ϭ extrapontine myelinolysis; GCS ϭ Glasgow Coma Scale; ODS ϭ osmotic

show abstract

Section: Osmotic Demyelination Syndromementioning

confidence: 91%

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Ismail¹,

Szóllics

Szólics

et al. 2013

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…MRI is the primary method for diagnosis, and is superior to computed tomography (12,13). Besides hypointense T1-and hyperintense T2-weighted lesions on MRI (14), DWI can be useful in diagnosing and predicting the prognosis of ODS.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia

Feng

Zhao

Zhou

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Central pontine myelinolysis (CPM), also known as osmotic demyelination syndrome, is a rare demyelinating disorder characterized by the loss of myelin in the center of the basis pontis. In this case report, an alcoholic patient with CPM and acquired demyelinating lesion of the basis pontis is described. The patient is a 70 year-old woman who presented with intermittent psychiatric symptoms and limb tremors following two months of alcohol abuse. During admission, magnetic resonance imaging (MRI) revealed hyperintensity on T2 weighted images and fluid-attenuated inversion-recovery imaging in the central pons without contrast enhancement. The patient's symptoms gradually improved following conservative treatment with vitamins B 1 and B 12 . The one month follow-up MRI showed a significant reduction of the pontine injury.

show abstract

“…MRIhas been shown to be effective to detect disorders such as CPM. Rippe et al (9) reported that a low intensity on the Tl-weighted image as well as a high intensity on the T2-weighted image in the central pons is characteristic ofCPM. Sterns et al (2) showed that two-thirds of the disorder have been found to be reversible based on neurological symptomssuch as coma, quadriplegia, pseudobulbar palsy, and behavioral changes.…”

Section: Discussionmentioning

confidence: 99%

Cortical Laminar Necrosis and Central Pontine Myelinolysis in a Patient with Sheehan Syndrome and Severe Hyponatremia.

et al. 1996

View full text Add to dashboard Cite

Hypoxic encephalopathy and osmotic demyelination are independent clinical entities. We describe a rare case with these two complications as demonstratedby magnetic resonance imaging (MRI). A 58-year-old womanhad adrenal crises twice a decade due to Sheehan syndrome. At the second crisis, hyponatremia wasremarkable with consciousness disturbance which was rapidly corrected by intraveneous administration of glucocorticoid and hypertonic saline. The maneuver improved consciousness disturbance, but resulted in hypokalemic ventricular fibrillation with circulatory failure. After the normalization of the circulation, however, her consciousness level deteriorated again. Repeated brain MRIrevealed acute and chronic phases of cortical laminar necrosis and central pontine myelinolysis.

show abstract

MR Imaging of Central Pontine Myelinolysis

Cited by 32 publications

References 0 publications

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia

Cortical Laminar Necrosis and Central Pontine Myelinolysis in a Patient with Sheehan Syndrome and Severe Hyponatremia.

Contact Info

Product

Resources

About