Presentation
Status presenting to ED with asystole in cardiac arrest.
Patient Data
Diffuse loss of grey-white matter differentiation with increased density of the infratentorial region. Diffuse cerebral edema.
Case Discussion
This case describes a patient who presents with pulselessness due to asystole for an unknown period of time. He was able to be resuscitated and was taken to the ED. A non-contrast CT was done and the results are above.
The diffuse cerebral edema and loss of grey-white matter differentiation is highly suggestive of anoxic brain injury radiographically. A pseudosubarachnoid hemorrhage sign is also present which demonstrates increased density within the basal cisterns. This sign can be seen in diffuse hypoxic injury due to cerebral edema.
This is a very important classic representation of anoxic brain injury. It often can go unnoticed because of the retained symmetry and lack of impressive features to the untrained eye. Despite its subtleties on CT, this is a "must call" diagnosis because of the devastating effects anoxia can have on the brain. Prognosis is poor and reperfusion and resuscitation efforts must be initiated immediately.