Anoxic brain injury

Case contributed by Dr Abdulrahman Abdo Ali Abbas

Presentation

In ICU after attempted resuscitation post drowning

Patient Data

Age: 4 years
Gender: Female
MRI

Diffuse swelling of cerebral sulci and effacement of bilateral lateral ventricles.

Swollen of the cerebellum and brain stem with upward transtentorial and downward transforaminal herniations. The fourth ventricle and basal cisternae are effaced. 

 loss of intra-arterial flow voids signal and the MRA show absence of intracranial vessels bilaterally.

 Abnormal signal intensity in cerebral and cerebellar hemispheres on DWI and ADC with MRS shows increase lactate/lipid peak, marked decrease of NAA.

 

Case Discussion

Hypoxic-ischemic brain injury is one of a major causes of brain death in the pediatric age group, the main radiological signs of brain death are the absence of blood flow to the brain and this can be demonstrated by Doppler ultrasound, CT angiography, MRI, MR angiography and isotope scanning.

In this case, diffuse swelling of the cerebrum, cerebellum, and brainstem with effacement of the ventricles and transtentorial herniation, signal changes were noted in the DWI and ADC, MRA showed absence of intracranial vessels above the foramen magnum.

 

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Case information

rID: 79165
Published: 21st Jun 2020
Last edited: 27th Nov 2020
Inclusion in quiz mode: Included
Institution: Khamis Mushayt Maternity and Children Hospital

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