MRI findings in brain death

Case contributed by Dr Shekhar Kalia

Presentation

25-year-old female patient with known chronic renal failure, status post renal transplant. She developed sepsis with toxic myocarditis and eventually had cardiac arrest and hypoxic-ischaemic brain injury.

Patient Data

Age: 25
Gender: Female
MRI

MRI Brain

MRI BRAIN shows tonsillar herniation, loss of intra-arterial flow voids signal, diffuse cortical high signal intensity and swelling of cerebral sulci on T2WI, effacement of bilateral lateral ventricles, high signal intensity in cerebral and cerebellar hemispheres on DWI due to cytotoxic edema and no significant blooming on GRE. 

Case Discussion

MR findings in a case of brain dead patient are usually diffuse swelling of the cerebral gyri and cerebellar cortex, demonstrating iso-hypointense signals on T1WI, getting iso-hyperintense on T2 WI suggestive of hypoxic-ischemic brain injury, with associated tonsillar herniation, effacement of bilateral lateral ventricles and loss of normal flow voids in the intracranial portions of both internal carotid arteries. MR angio may show a paucity of intracranial vessels at/above the level of the supraclinoid portions of the bilateral internal carotid arteries.

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Case information

rID: 30173
Case created: 23rd Jul 2014
Last edited: 6th Oct 2015
Inclusion in quiz mode: Included

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