Uremic encephalopathy with isolated brainstem involvement revealed by magnetic resonance image: a case report.
BACKGROUND
Uremic Encephalopathy (UE) is a neurological complication associated with acute or chronic renal failure. Imaging findings of UE may present involvement of the basal ganglia, cortical or subcortical regions, and white matter. We report a rare case of UE caused by neurogenic bladder with isolated brainstem involvement revealed by magnetic resonance imaging (MRI). Immediate therapy resulted in full recovery of neurological signs and changes on MRI.


CASE PRESENTATION
A 14-year-old Han Chinese woman with a history of chronic renal failure caused by neurogenic bladder. On admission, she was unconscious and her pupils presented different sizes, while her vital signs were normal. MRI showed high signal in the dorsal pontine base and in the mid brain on fluid-attenuated inversion-recovery (FLAIR) imaging and on T2-weighted imaging while the signal was normal on diffusion-weighted images (DWI). Blood analysis revealed renal failure and acidosis. After urinary retention treatment and acidosis correction, the patient soon recovered. Follow-up MRI 2 months after the discharge revealed complete resolution of UE in the brainstem.


CONCLUSION
We reported a rare case of a patient with UE that had unusual imaging manifestations for whom timely diagnosis and treatment assured recovery.
['Jia|Li-Jing|LJ|http://orcid.org/0000-0002-6920-6619', 'Qu|Zhen-Zhen|ZZ|', 'Zhang|Xue-Qian|XQ|', 'Tian|Yu-Juan|YJ|', 'Wang|Ying|Y|']
D000293:Adolescent D001927:Brain Diseases D001933:Brain Stem D038524:Diffusion Magnetic Resonance Imaging D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D066127:White Matter
Uremic encephalopathy Brainstem Magnetic resonance images Renal failure Posterior reversible encephalopathy syndrome