Brain Atrophy in Patient with Delirium Tremens

Abstract

Approximately 3-5% of individuals undergoing alcohol cessation or reduction after chronic overuse develop delirium tremens (DT), a severe manifestation of alcohol withdrawal syndrome. Long-term alcohol consumption has been associated with brain atrophy. This case report discusses the findings of an early-onset cerebral atrophy in an alcohol withdrawal patient with DT. A 53-year-old man presented to the emergency unit with nausea and flank pain following the ingestion of a cocktail of alcoholic beverages the day prior. Physical examination showed an elevated blood pressure (223/146 mmHg) with no history of seizure. Within two days, the patient had shown a deterioration of consciousness. He was transferred to the high care unit and referred to the psychiatry department for signs of agitation. Psychiatric assessment revealed that the patient was delirious and experiencing auditory and visual hallucinations. A multi-slice computed tomography scan revealed cerebral atrophy. This case highlights the co-occurrence of brain atrophy and DT, emphasizing the importance of neuroimaging in patients with a history of alcohol use. Early recognition of cerebral changes may facilitate timely intervention, improve management of severe withdrawal, and guide preventive strategies in alcohol use disorder.