Shimane Journal of Medical Science

Shimane University Faculty of Medicine
ISSN :0386-5959(冊子体)
ISSN :2433-2410(オンライン)

クリエイティブ・コモンズ・ライセンス
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Shimane Journal of Medical Science 15
1997-09-01 発行

A case of nonketotic hyperosmolar coma with pontine and extra-pontine myelinolysis on magnetic resonance imaging

岡田 和梧
小林 祥泰
河野 直人
山形 真吾
山口 修平
ファイル
内容記述(抄録等)
We present a patient with nonketotic hyperosmolar coma who exhibited extra-pontine myelinolysis as demonstrated by the findings including magnetic resonance imaging (MRI). The lesions appeared as widespread symmetrical hyperintensities that involved the subcortical white matter of the frontal, temporal, and parietal lobes. Thinning of the cerebral cortices was observed. The center of the pons was only slightly affected. The patient ultimately died of pneumonia. The abrupt changes in serum sodium concentration and/or osmolarity, induced not only by treatment of hyponatremia, but by alteration to the hypernatremic state, may have contributed to the development of pontine and extra-pontine myelinolysis. To our knowledge, this is the first case in which the MRI results corresponded to previously reported autopsy findings of extra-pontine form by Okeda et al. in pontine and extra-pontine myelinolysis.