case_images: PMC9577390_01
case_images: Non-contrast computed tomography of the head at the level of the basal ganglia (a) and centrum semiovale (b) does not show any obvious abnormalities.
case_images: qmj-2022-04-045.g001.jpg
case_images: PMC9577390_01_qmj-2022-04-045.g001.jpg
case_images: fig1
case_images: Her CT of the brain was normal (Figure 1), following which a cerebrospinal fluid (CSF) was sent for examination.
case_images: Change in serum sodium (mEq/L) over a few days (D).
case_images: qmj-2022-04-045.g002.jpg
case_images: PMC9577390_01_qmj-2022-04-045.g002.jpg
case_images: fig2
case_images: Serial monitoring of serum sodium was conducted using arterial blood gas analysis (Figure 2).
case_images: Axial tbl2 (a, b) images show abnormal hyperintense signal involving bilateral middle cerebellar peduncles, splenium of the corpus callosum, and posterior limb of the internal capsule. The coronal fluid-attenuated inversion recoveryimage (c) demonstrated selective involvement of the corticospinal tract (short arrows) giving a "wine-glass" appearance. The involved areas show restriction on diffusion-weighted images (d,e) with evidence of microhemorrhages on the susceptibility-weighted images (f). The imaging features are characteristic of hypernatremic encephalopathy with osmotic myelinolysis and rhabdomyolysis
case_images: qmj-2022-04-045-g003.jpg
case_images: PMC9577390_01_qmj-2022-04-045-g003.jpg
case_images: fig3
case_images: The imaging features were suggestive of postpartum hypernatremic encephalopathy with osmotic extrapontine myelinolysis (Figure 3).