It is usually associated with severe systemic damage, such as with:
- hypertensive crises
- severe sepsis / severe inflammatory condition
- hypoxic-ischemic encephalopathy
- intoxication / metabolic systemic disease
The radiographic features are those of both cytotoxic and vasogenic cerebral oedema. Hence, both the grey and white matter are affected, with sulci effacement, loss of cortical differentiation and finger-like hypodensities (CT-scan) / hypersignal (T2/FLAIR).
Treatment and prognosis
This finding usually carries a very poor prognosis. Cerebral herniation is almost inevitable unless aggressive treatment of the underlying aetiology is quickly initiated.