Global hypoxic ischaemic encephalopathy

Case contributed by Dr Alexandra Stanislavsky

Presentation

Prolonged thoracic crush injury, asystolic arrest.

Patient Data

Age: 50
Gender: Male
CT

Initial CT Brain

CT

Follow-up CT at 24 hours

MRI

48 hours from initial CT.

Widespread symmetrical cortical and deep grey matter (basal ganglia, substantia nigra and periaqueductal grey) restricted diffusion. T2 signal abnormality involves globus pallidus and caudate nucleus.  

Case Discussion

This case demonstrates the imaging findings of severe hypoxic brain injury, with extensive, symmetrical involvement of deep grey matter structures and cortical laminar necrosis.  In the acute period, DWI is earliest to demonstrate the abnormality, and is most sensitive in showing its extent.

The selective vulnerability of grey matter is thought to relate to its higher metabolic demand, as well as its susceptibiity to glutamate toxicity.

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Case information

rID: 16329
Case created: 11th Jan 2012
Last edited: 21st Sep 2015
Inclusion in quiz mode: Included

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