# Acquired Hepatocerebral Degeneration in a Septic Patient: Hospital Course and MRI Findings

## TL;DR

A case report describes a patient with alcoholic cirrhosis who developed acquired hepatocerebral degeneration, highlighting MRI findings and the importance of managing precipitating factors like infection.

## Contribution

This case emphasizes the diagnostic role of MRI and the management of precipitating factors in acquired hepatocerebral degeneration.

## Key findings

- MRI showed T1 hyperintensities in the globus pallidus, confirming the diagnosis of AHD.
- Management of infection, hyperammonemia, and other factors improved the patient's cognitive status.

## Abstract

Acquired hepatocerebral degeneration (AHD) is a rare neuropsychiatric disorder affecting cirrhotic patients, often presenting with neuropsychiatric symptoms triggered by a precipitating factor. Magnetic resonance imaging (MRI) showing T1 hyperintensities in the globus pallidus is diagnostic. In this case report, a 40-year-old female patient with alcoholic cirrhosis presented with generalized swelling, jaundice, fever, and signs of septic shock. After stabilization, changes in cognition while this patient was hospitalized prompted the management of several different factors, including the underlying infection, hypernatremia, vitamin deficiency, alcohol withdrawal, and hyperammonemia. Infectious disease consultation helped determine the antibiotic selection and dosage for bacteremia and later concerns for meningitis. This case report illustrates the role of MRI in diagnosing AHD and highlights the importance of how managing precipitating factors such as infection and hyperammonemia is key to improving cognitive status.