BMJ Case Reports 2012; doi:10.1136/bcr.11.2011.5198
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Multiple brain lesions in a young man with hypernatraemia

  1. Jorge Resende Pereira1
  1. 1Department of Neuroradiology, Hospital Pedro Hispano, Porto, Portugal
  2. 2Department of Neurology, Hospital Pedro Hispano, Porto, Portugal
  1. Correspondence to Dr Ines Rego, i.cabralrego{at}


A 47-year-old patient with a history of chronic alcoholism was admitted to our hospital with sudden loss of consciousness, respiratory failure and severe hypernatraemia (173 mEq/l); he had no other alterations in routine laboratory analyses. During admittance he experienced mental status fluctuations and developed a spastic tetraparesis, a bilateral Babinski sign and a bilateral facial paresis (locked in status). Brain MRI (figure 1) showed symmetric lesions in the pons and thalami with …

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