Toxic and Acquired Metabolic Brain Lesions Cases

Toxic and metabolic brain disorders are not common but CNS imaging plays a significant role in determining the most probable cause and leading for treatment planning.
In born errors of metabolism and HIE may share similar imaging features with toxic encephalopathies however patients presentation is completely different in each situation.
The most affected parts of brain are deep gray nuclei, cortical gray matter and peri ventricular white matter most of the times in symmetric and bilateral distribution.
Additionally imaging has a key role in providing prognostic information in which extensive lesions of gray matter are related to poor prognosis, while lesions with solely white matter involvement can lead to a reversible state.
There are some classifications for patterns of brain involvement in toxic/ metabolic encephalopathies which are closely related to the Patho physiologic mechanism of damage. Their identification is important because each pattern can guide us to the most likely diagnosis.