Liver Disease

Findings:
Axial T1 and T2 weighted images show symmetric abnormal signal in the globus pallidus.

Differential Diagnosis/Discussion:
The differential diagnosis of symmetric abnormal signal in the basal ganglia is broad, including metabolic etiologies (mitochondrial disorders (Leigh), methylmalonic acidemia, Wilson's disease, Hallervorden-Spatz), toxins (CO, methanol, cyanide), and hypoxic insult. Most of these disorders cause nonspecific T1 hypointensity/T2 hyperintensity with the exception of  Hallervorden-Spatz. The pattern of symmetric T1 hyperintensity may be seen with calcification, TPN, and liver disease.

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