Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2015  |  Volume : 18  |  Issue : 3  |  Page : 342-344

Diffusion MRI features of acute encephalopathy due to stopping steroid medication abruptly in congenital adrenal hyperplasia


1 Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
2 Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

Correspondence Address:
Asli Serter
Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.152086

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Congenital adrenal hyperplasia (CAH) is characterized by adrenal steroid biosynthesis defect. Steroid replacement therapy should be performed regularly in these patients. Adrenal crisis may be present in acute stress due to increased cortisol requirements or in steroid deficiency due to stopping steroid medication abruptly. In patients with acute adrenal insufficiency, severe hypotension or hypovolemic shock occurs typically. Acute encephalopathy can be seen due to hypoxia, hypervolemia, or hypoglycemia. Diffusion restriction can be seen in cortical-subcortical regions of frontal and parieto-occipital lobes and in splenium of corpus callosum. In CAH patients with neurologic symptoms, Diffusion weighted images (DWI) is very important in the diagnosis and follow-up of acute encephalopathy.


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