J Korean Soc Radiol.  2012 Mar;66(3):217-220. 10.3348/jksr.2012.66.3.217.

Dialysis Disequilibrium Syndrome-Induced Cerebral Edema in a Patient with Uremia Following Hemodialysis: A Case Report

• Kim JM
• Kim HC

• KMID: 1439416
• DOI: http://doi.org/10.3348/jksr.2012.66.3.217

Abstract

Dialysis disequilibrium syndrome is a metabolic complication that can be caused by rapid removal of plasma urea during hemodialysis. Dialysis disequilibrium syndrome can lead to osmotic demyelinating syndrome. This case report describes one case of encephalopathy accompanied by dialysis disequilibrium syndrome with imaging findings acquired immediately after hemodialysis in a 55-year-old woman with chronic renal failure. The patient was observed to present repetitive seizures and sudden deterioration of consciousness immediately after hemodialysis. Shortly after the onset of symptoms, the patient underwent a CT scan. The imaging findings of the CT scan reveal symmetrical diffuse white matter edema of bilateral cerebral hemispheres that extends to the pons along the internal capsule. A follow-up MRI taken two years later shows that reversible changes without damage have occurred in the lesions. The patient can thus be seen to present symptoms characteristically associated with dialysis disequilibrium syndrome, while brain imaging reveals diffuse reversible brain edema.

MeSH Terms

Brain Edema
Cerebrum
Consciousness
Dialysis
Edema
European Continental Ancestry Group
Female
Follow-Up Studies
Humans
Internal Capsule
Kidney Failure, Chronic
Middle Aged
Neuroimaging
Plasma
Pons
Renal Dialysis
Seizures
Urea
Uremia
Urea

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