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Internal watershed cerebral infarction

Case contributed by: Dr Frank Gaillard

Presentation:

Found unconscious.

Patient Data:

Age: Young adult

CT brain

Modality: CT

Non contrast CT demonstrates ill defined bilateral peri-ventricular white matter low density. 

MRI brain.

Modality: MRI

MRI confirmed the CT changes, demonstrating restricted diffusion and high T2 signal seen deep to the cortex. 

Case Discussion:

This young patient had prolonged hypotension as a result of a drug overdose.

This is a characteristic appearance of an internal or deep watershed infarct. 

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