EC Clinical and Medical Case Reports

Uremic encephalopathy is a rare but reversible neurological complication of severe renal failure. We report the case of a 64-year- old woman presenting with acute confusion whose initial brain CT was normal. Brain MRI revealed the characteristic lentiform fork sign, consisting of bilateral symmetric peri-lenticular and basal ganglia hyperintensities with imaging features of vasogenic edema. Laboratory investigations confirmed severe renal failure, establishing the diagnosis of uremic encephalopathy. Recognition of this characteristic MRI pattern is essential, as it facilitates early diagnosis, prompts timely metabolic treatment, and may improve clinical outcomes.

Keywords: Uremic Encephalopathy; Lentiform Fork Sign; MRI Brain; Basal Ganglia; Metabolic Encephalopathy

1. Kumar S., et al. “MR imaging findings in uremic encephalopathy: the lentiform fork sign”. American Journal of Neuroradiology 8 (1998): 1499-1501.
2. Agarwal SK and Chang A. “Uremic encephalopathy”. Kidney International 5 (2014): 1081-1088.
3. Krishnan AV and Kiernan MC. “Neurological complications of chronic kidney disease”. Nature Reviews Neurology 3 (2020): 173-188.