MAGNETIC RESONANCE IMAGING AND DERMATOLOGICAL CORRELATES IN ENCEPHALOPATHY: A PROSPECTIVE OBSERVATIONAL STUDY
DOI:
https://doi.org/10.22159/ajpcr.2025v18i11.56505Keywords:
Encephalopathy, Magnetic resonance imaging,, Dermatological manifestations, Diagnostic imaging, Prognosis, Brain hyperintensities, Posterior reversible encephalopathy syndrome, Hepatic encephalopathy, Cutaneous signs, Neuroimaging.Abstract
Objectives: We hypothesized that specific, region-based magnetic resonance imaging (MRI) patterns and dermatological manifestations are strongly associated with distinct encephalopathy subtypes and can predict clinical outcomes in patients presenting with altered mental status.
Methods: This prospective observational study included 100 adult patients who had presented with clinical features of encephalopathy at a tertiary care hospital over a period of 24 months (January 2020 to December 2021). Detailed clinical, laboratory, and dermatological evaluations were conducted. All participants underwent standardized MRI brain scans. Encephalopathy subtypes were classified based on clinical, imaging, and laboratory findings. Statistical analysis assessed the association of imaging and skin findings with clinical outcomes, including mortality.
Results: MRI abnormalities were observed in 80% of patients, with region-specific patterns across encephalopathy types. Parieto-occipital hyperintensities predominated in posterior reversible encephalopathy syndrome (PRES), while basal ganglia involvement was prominent in hepatic encephalopathy. Cutaneous manifestations were common in autoimmune (100%) and hepatic (84.6%) encephalopathies, providing diagnostic clues. Overall mortality was 24%, with the highest rates in septic and hemorrhagic encephalopathy (62% each), and no deaths in PRES or metabolic encephalopathies. Dermatological findings and MRI patterns correlated with diagnosis and prognosis, supporting a multimodal assessment approach.
Conclusion: MRI-based region-specific patterns and systematic dermatological examination offer a comprehensive and practical approach to diagnosing and prognosticating encephalopathy. This integrated model enhances early identification of reversible conditions and helps guide therapeutic strategies. The findings support incorporating dermatological evaluation into routine encephalopathy assessments and encourage further multicenter validation of this multidisciplinary diagnostic framework.
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