Diffuse hypoxia ischemic brain injury

Case contributed by Hoe Han Guan


Cardiac arrest, post cardiorespiratory resuscitation with prolonged poor Glasgow Coma Scale (GCS)

Patient Data

Age: 30 years
Gender: Male

Generalized diffuse cerebral edema with loss of normal grey-white differentiation. 
Hypoattenuation of the cerebral hemispheres, especially basal ganglia with sparing of the cerebellum, gives rise to the "white cerebellum sign".
Hyperdense falx cerebri, tentorium cerebelli, and subarachnoid spaces appear filled with "blood" relative to the brain parenchyma, giving the appearance of pseudosubarachnoid hemorrhage.
Marked significant mass effect with tonsillar and uncal herniation and slit-like effacement of the ventricles. No midline shift. No acute intracranial hemorrhage.

Case Discussion

These CT appearances are consistent with hypoxic-ischemic brain injury with significant cerebral herniation.

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