Presentation
Brought arrested to ER. Revived by CPR. Currently on triple inotrope and ventilatory support.
Patient Data
Diffuse gyral edema, more evident in bilateral parieto occipital lobes more than the frontal lobes.
Slit like lateral ventricles. Effaced bilateral Sylvian fissures and pentagon of basal cisterns.
Loss of grey white matter differentiation involving cerebral lobes as well as between deep grey matter nuclei. Hypoattenuating bilateral gangliocapsule, thalami, central mid brain and pons, bilateral cerebellar hemispheres.
No descending transtentorial or tonsillar herniation.
Case Discussion
In this case, CT was requested to delineate extent of neuroparenchymal injury. There is evidence of both superficial grey white matter as well as deep basal ganglia and brain stem involvement. All of these features point towards severe global hypoxic ischemic injury with a grave prognosis.
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