Hypoxic-ischaemic brain injury

Case contributed by Dr Aruna Pallewatte

Presentation

Presented in comatose condition and fits. Resuscitated for cardiac arrest 5 days ago.

Patient Data

Age: 50
Gender: Male
MRI

The findings are well seen in DWI showing restricted diffusion in cortical grey matter bilaterally, both thalami and basal ganglia. Same areas were low signal in T1 and high signal on T2 and FLAIR. No evidence of hemorrhages. No mass effect or midline shift.

Case Discussion

Hypoxic ischemic injury in adults is usually following cerebral hypoxia commonly as a result of cardiac arrest, drowning and asphyxiation. If ischemia is mild it manifests as watershed zone infarcts. Severe hypoxic injury primarily affects the gray matter structures such as the basal ganglia, thalami, cerebral cortex and hippocampi. Cerebellar injury can also occur. Diffusion-weighted MR imaging shows restricted deffusion in affected areas within the first few hours after a hypoxic-ischemic event. Changes in T1 and T2 images take longer to develop.

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Case information

rID: 31624
Case created: 18th Oct 2014
Last edited: 8th Feb 2016
Inclusion in quiz mode: Included

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