Extrapontine Myelinolysis and Cortical Laminar Necrosis Caused by Severe Hypernatremia following Peritoneal Lavage for Ruptured Hydatid Cyst of the Liver
Restricted accessResearch articleFirst published online April, 2011
Extrapontine Myelinolysis and Cortical Laminar Necrosis Caused by Severe Hypernatremia following Peritoneal Lavage for Ruptured Hydatid Cyst of the Liver
Extrapontine myelinolysis (EPM) and cortical laminar necrosis (CLN) have rarely been reported in association with severe hypernatremia. We describe a patient with EPM associated with CLN following severe hypernatremia due to hypertonic peritoneal lavage after a ruptured hydatid cyst of the liver. Clinical and neuroimaging findings in acute stage and serial brain MRI at two and five month follow-up are discussed in detail.
AdamsRDVictorMManacallEL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. Arch Neurol Psychiatry. 1959; 81: 154–172.
2.
BrownWD. Osmotic demyelination disorders: central pontine and extrapontine myelinolysis. Curr Opin Neurol. 2000; 13: 691–697.
3.
MartinRJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry. 2004; 75: 22–28.
4.
CalakosNFischbeinNBaringerJR. Cortical MRI findings associated with rapid correction of hyponatremia. Neurology. 2000; 55: 1048–1051.
MocharlaRSchexnayderSMGlasierCM. Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration. Pediatr Radiol. 1997; 27: 785–787.
7.
DobatoJLBarrigaFJParejaJA. [Extrapontine myelinolyses caused by iatrogenic hypernatremia following rupture of a hydatid cyst of the liver with an amnesic syndrome as sequela]. Rev Neurol. 2000; 31: 1033–1035.
8.
RighiniARamenghiLZirpoliS. Brain apparent diffusion coefficient decrease during correction of severe hypernatremic dehydration. Am J Neuroradiol2005; 26: 1690–1694.
9.
FiratAKKarakasHMYakinciC. Encephalopathy due to hypernatrimic dehydration: computerized tomography and magnetic resonance imaging findings: case report. Turkiye Klinikleri J Med Sci.2006; 26: 575–578.
10.
AdrogueHJMadiasNE. Hyponatremia. N Engl J Med.2000; 342: 1581–1589.
11.
AdrogueHJMadiasNE. Hypernatremia. N Engl J Med.2000; 342: 1493–1499.
12.
BorraSIBeredoRKleinfeldM. Hypernatremia in the aging: causes, manifestations, and outcome. J Natl Med Assoc. 1995; 87: 220–224.
13.
AlbiABaudinFMatmarM. Severe hypernatremia after hypertonic saline irrigation of hydatid cysts. Anesth Analg. 2002; 95: 1806–8.
14.
Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis. Bull World Health Organ. 1996; 74: 231–242.
15.
TaylorBRLangerB. Current surgical management of hepatic cyst disease. Adv Surg. 1997; 31: 127–148.
16.
GageTPVivianG. Hypernatremia after hypertonic saline irrigation of an hepatic hydatid cyst. Ann Intern Med.1984; 101: 405.
17.
GullansSRVerbalisJG. Control of brain volume during hyperosmolar and hypoosmolar conditions. Annu Rev Med.1993; 44: 289–301.
18.
AyusJCArmstrongDLArieffAI. Effects of hypernatraemia in the central nervous system and its therapy in rats and rabbits. J Physiol. 1996; 492: 243–255.
19.
SoupartAPenninckxRNamiasB. Brain myelinolysis following hypernatremia in rats. J Neuropathol Exp Neurol. 1996; 55: 106–113.
20.
SoupartAPenninckxRStenuitA. Reinduction of hyponatremia improves survival in rats with myelinolysis-related neurologic symptoms. J Neuropathol Exp Neurol. 1996; 55: 594–601.
21.
HanBKLeeMYoonHK. Cranial ultrasound and CT findings in infants with hypernatremic dehydration. Pediatr Radiol. 1997; 27: 739–742.
SawadaHUdakaFSeriuN. MRI demonstration of cortical laminar necrosis and delayed white matter injury in anoxic encephalopathy. Neuroradiology. 1990; 32: 319–321.
24.
NabatameHFujimotoNNakamuraK. High intensity areas on noncontrast T1-weighted MR images in cerebral infarction. J Comput Assist Tomogr. 1990; 14: 521–526.
25.
SiskasNLefkopoulosAIoannidisI. Cortical laminar necrosis in brain infarcts: serial MRI. Neuroradiology. 2003; 45: 283–288.
26.
DocziTSchwarczA. Correlation of apparent diffusion coefficient and computed tomography density in acute ischemic stroke. Stroke. 2003; 34: 17–18.
