Presentation
Found down in cardiac arrest. Evaluate for trauma or hemorrhage.
Patient Data
There is total loss of gray-white matter differentiation throughout both cerebral hemispheres, as well as the cerebellum. There is severe edema with significant mass effect on the ventricles. The basal cisterns are not effaced.
There is bone mineralization of the cervical spine is decreased. There are multilevel degenerative changes comprising endplate osteophyte formation as well as uncovertebral and facet arthropathy. Otherwise, there are no fractures.
There is no radiotracer uptake seen within the brain. There is increased radiotracer uptake within the nasal region.
Case Discussion
This is a case of a cardiac arrest leading to global anoxic injury, which in turn lead to brain death as diagnosed on a cerebral perfusion study (hot nose sign and empty lightbulb sign are seen). The patient was found to have cocaine in their urinary drug screen, which may have been the cause of her cardiac arrest.
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