Is trying to remember toxic encephalopathy patterns making you toxic?
Does memorizing metabolic encephalopathy patterns put you into a metabolic coma?
Don't become encephalopathic!
Here is the cheat sheet of the encephalopathy patterns you NEED to know & how to remember them!
➡️Corpus Callosum:
🔸Lesions here are called cytotoxic lesions of the corpus callosum or CLOCC.
🔸Usually transient from cytotoxicity, especially viral infections.
🔸Remember they are commonly viral & transient bc CLOCC lesions are on the CLOCK
➡️Central Pons:
🔸Usually osmotic demyelination
🔸Remember this bc the T2 hyperintensity is in the shape of O for Osmotic
➡️Dentate:
🔸Usually flagyl toxicity
🔸Remember this bc the wavy appearance of the dentate looks like a FLAG for FLAGyl
➡️Corticospinal tract:
🔸Usually from cobalamin deficienty
🔸Remember cortiCOspinal for CObalamin
➡️Symmetric Gray Matter:
🔸Differential is EXTENSIVE
🔸Remember the differential list for deep gray is deep!
➡️Cortical Gray Matter:
🔸Typically hypoglycemia & hyperammonemia
🔸Remember it looks like the brain has been coated in shimmering sugar = related to glucose
🔸Hyperammonemia has about 1000 Ms in it & the undulated cortex looks like an M
➡️Symmetric White Matter:
🔸Commonly from chasing the dragon (heroin) & methotrexate
🔸Remember that the puffy white matter signal looks like the smoke from a dragon
🔸Remember methotrexate as methoTRACTSate = affects many white matter TRACTS
➡️Posterior subcortical edema:
🔸This is PRES or posterior reversible encephalopathy
🔸So if it’s all POSTERIOR, think POSTERIOR reversible encephalopathy
➡️Asymmetric White Matter:
🔸This is usually demyelinating from chemotherapy
🔸Demyelinating lesions have a C shaped pattern of enhancement
🔸So if you see a C enhancing think of C-hemotherapy
Now you know all the toxic/metabolic encephalopathy patterns.
So hopefully now remembering the patterns of toxic/metabolic won’t seem so diabolic!