Hypoxic-ischemic brain injury

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

5 days post cardiac arrest with prolonged downtime. Persistently reduced GCS of 11.

Patient Data

Age: 45
Gender: Male

5 days post cardiac arrest

ct

Loss of CT visibility of the caudate and lentiform nuclei bilaterally (hypoattenuation) 5 days after a cardiac arrest consistent with hypoxic-ischemic brain injury. 

On day of cardiac arrest

ct

On day of cardiac arrest these is no appreciable abnormality on CT. Specifically the grey-white differentiation of the basal ganglia is preserved. 

Annotated image

Hypoxic-ischemic brain injury. Preserved caudate head grey matter density on day 1 (yellow arrows) compared to loss of caudate head density on day 5 (blue arrows) with absence of differentiation between the nuclei and the adjacent internal capsule white matter.    

Case Discussion

Loss of CT visibility of the caudate and lentiform nuclei (hypoattenuation) 5 days after a cardiac arrest consistent with hypoxic-ischemic brain injury

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