Presentation
Post cardiac arrest.
Patient Data
Evidence of hypoxic-ischemic brain injury. Widespread loss of grey-white matter differentiation.
There is complete global effacement of the cerebral sulci, subarachnoid cisterns, and cerebellar folia.
Reversal sign is present within the posterior cerebellum. Pseudo-subarachnoid hemorrhage is seen in the hyper-dense appearance of the falx cerebri and tentorium cerebelli compared to the surrounding edematous brain tissue.
Uncal herniation is seen bilaterally. Significant cerebellar tonsillar herniation is also present.
Case Discussion
Extensive anoxic brain injury secondary to cardiac arrest.
Hypoxic-ischemic brain injury is a common sequela of prolonged cardiac arrest, and can present clinically ranging from subtle cognitive impairment to brain death 1.
Other causes of hypoxic-ischemic brain injury in adults include hypoxia secondary to severe respiratory failure, asphyxiation, drowning, and carbon monoxide poisoning.
Case submitted by Dr. N. Larocque.
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