15 November 2022
: Case report 
Late-Onset Ornithine Transcarbamylase Deficiency Complicated with Extremely High Serum Ammonia Level: Prompt Induction of Hemodialysis as the Key to Successful Treatment
Challenging differential diagnosis, Management of emergency care, Rare disease
Satsuki Yamamoto12AEF, Shun Yamashita
1AEF*, Toshihiko Kakiuchi 3AE, Kazuya Kurogi14AEF, Tomoyo M. Nishi1AEF, Masaki Tago 1AEF, Shu-ichi Yamashita1AEF
DOI: 10.12659/AJCR.937658
Am J Case Rep 2022; 23:e937658
Figure 3. Cranial computed tomography findings on hospital days 3 and 5. (A, B) on hospital day 3, (C, D) on hospital day 5. Cranial computed tomography on hospital day 3 shows whole-brain edema with an indistinct cortico-medullary junction at the base of the brain. There is narrowing of the Sylvian fissure (A, arrows) and lateral ventricles (B, arrowheads) with no abnormal findings in the basal ganglia. Cranial computed tomography on hospital day 5 shows the marked improvements in whole-brain edema, the indistinctness of the cortico-medullary junction, and the narrowing of the Sylvian fissure (C, arrows). The narrowing of the lateral ventricles has persisted (D, arrowheads).