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American Journal of Neuroradiology 25:1247-1250, August 2004
© 2004 American Society of Neuroradiology

Case Report
BRAIN

Reversal of Parkinsonism and Portosystemic Encephalopathy Following Embolization of a Congenital Intrahepatic Venous Shunt: Brain MR Imaging and 1H Spectroscopic Findings

Antônio J. da Rochaa, Flávio T. Bragaa, Carlos J. da Silvaa, Antônio C. M. Maia, Jra, Guilherme S. Mourãob and Rubens J. Gagliardic

a Centro de Medicina Diagnóstica, Setor de Imagem, Laboratório Fleury, São Paulo Brazil
b Medimagem, Hospital Beneficiência Portuguesa de São Paulo, São Paulo Brazil
c Department of Neurology, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo Brazil

Address correspondence to Carlos Jorge da Silva, MD, Centro de Medicina Diagnóstica, Setor de Imagem, Laboratório Fleury, Rua Cincinato Braga, 282, Paraíso, CEP 01333910, São Paulo-SP, Brazil

Summary: Parkinsonism and portosystemic encephalopathy (PSE) are cerebral disorders associated with motor and neuropsychological dysfunctions that may occur in patients with chronic liver disease. We describe a patient with parkinsonism and neuroradiologic and 1H spectroscopic findings of PSE associated with a large congenital intrahepatic portosystemic venous shunt. Chronic liver disease was absent. After endovascular treatment, we documented a progressive reversal of parkinsonism and PSE on the basis of clinical, neuroradiologic, and spectroscopic criteria.




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