Fig 2.

Patient 1. Follow-up brain CT scan after 7 days in patient 1, who continued to deteriorate neurologically despite therapeutic measures. Repeat plasma ammonium level decreased to 110 μmol/L. A, Effacement of suprasellar cisterns in keeping with bilateral uncal herniation is seen. B, Image at a level above the lateral ventricles shows widespread loss of cortical sulci and gray-white differentiation, in keeping with cerebral edema. The patient died soon after the study was performed.