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Year : 2015  |  Volume : 2  |  Issue : 2  |  Page : 112-115

Postpartum hypernatremic cerebral encephalopathy with osmotic myelinolysis: Report of two cases and review with emphasis on magnetic resonance imaging findings


1 Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
2 Department of Neuroradiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
3 Department of Neurology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India

Correspondence Address:
Santosh Rai Phajir Vishwanath
Department of Radiodiagnosis, Kasturba Medical College and Hospital, Manipal University, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2349-4220.172893

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Postpartum complications are diverse. Electrolyte imbalance with hypernatremia can occur secondary to underlying postpartum complication or can arise de novo. Hypernatremia causes demyelination similar to hyponatremia but predominantly involves extra-pontine structures. Here, we present two cases, one classical and another a variant of a recently described entity called postpartum hypernatremic encephalopathy with osmotic demyelination. The more classical appearance is altered signal intensity changes in the posterior limb of internal capsules, external capsule, crus cerebri, corticopontine tracts, middle cerebellar peduncle, hippocampus, fornix, and cerebellar white matter with classical wine glass appearance on coronal T2-weighted images. The nonclassical case shows a different and atypical imaging finding of the same disease with small focal transient altered signal intensity changes in the splenium of corpus callosum. Both the patients recovered with conservative management of the electrolyte imbalance.


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