Presentation
In ICU after attempted resuscitation post drowning
Patient Data
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.