Nie T, He JL. Wernicke's encephalopathy in a rectal cancer patient with atypical radiological features: A case report. World J Clin Cases 2021; 9(25): 7600-7604 [PMID: 34616832 DOI: 10.12998/wjcc.v9.i25.7600]
Corresponding Author of This Article
Tian Nie, Doctor, Department of Neurology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. nietianshn@163.com
Research Domain of This Article
Neuroimaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7600-7604 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7600
Wernicke's encephalopathy in a rectal cancer patient with atypical radiological features: A case report
Tian Nie, Jian-Li He
Tian Nie, Jian-Li He, Department of Neurology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Nie T and He JL analyzed the data and drafted the manuscript; Nie T designed the study and revised the manuscript; all authors have read and approved the final manuscript.
Supported bythe Hangzhou Science and Technology Bureau, No. 20191203B84.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tian Nie, Doctor, Department of Neurology, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. nietianshn@163.com
Received: April 22, 2021 Peer-review started: April 22, 2021 First decision: May 24, 2021 Revised: May 25, 2021 Accepted: July 14, 2021 Article in press: July 14, 2021 Published online: September 6, 2021
Abstract
BACKGROUND
Wernicke's encephalopathy is a disease caused by thiamine deficiency. The lesions usually involve the periphery of the aqueduct, midbrain, tectum, third ventricle, papillary body, and thalamus. It is very rare to affect the vermis and cerebellar hemispheres.
CASE SUMMARY
We report a 77-year-old female patient admitted to the emergency department of our hospital for 2 d of unconsciousness. Brain magnetic resonance imaging showed increased diffusion weighted imaging signals in the bilateral thalamus, periventricular regions of the third ventricle, corpora quadrigemina, vermis, and cerebellar hemispheres. Wernicke's encephalopathy was considered. She was given thiamine therapy and became conscious after the treatment.
CONCLUSION
Wernicke's encephalopathy may have various imaging manifestations. Clinicians should keep in mind that Wernicke’s encephalopathy may occur in patients who experience prolonged periods of malnutrition.
Core Tip: Wernicke's encephalopathy is a disease caused by thiamine deficiency. Wernicke's encephalopathy may have various imaging manifestations. Typically, the lesions are distributed symmetrically in the thalamus, mammillary bodies, corpora quadrigemina, and periaqueductal areas. Lesions can also be found atypically in the cerebellum, cranial nerve nucleus, red nucleus, caudate nucleus, cerebral cortex, and other atypical areas. We report a female patient with atypical lesions involving the vermis and cerebellar hemispheres. She was given thiamine therapy and became conscious after the treatment.
