Presentation
Patient nine days after a suicide attempt by strangulation with initial out-of-hospital cardiac arrest. Clinical presentation is of an unconscious patient with no waking reaction and no brainstem reflexes, beyond respiratory drive, as well as repetitive seizures.
Patient Data
Diffuse diffusion restriction of the supratentorial white matter with correlating FLAIR-hyperintense signal changes. In addition, bihemispheric FLAIR-hyperintense signal changes of the cortical ribbon and basal ganglia on both sides with only minor correlative diffusion restriction in the peri-rolandic cortex.
Considering the medical history, the findings are consistent with delayed posthypoxic leukoencephalopathy after hypoxic-ischemic encephalopathy.
Case Discussion
While the initial stage of hypoxic-ischemic encephalopathy is characterized by changes in the gray matter (especially cortical ribbon and basal ganglia), in some cases pronounced changes in the white matter can be observed with some latency, which is thought to reflect white matter demyelination.
Unable to process the form. Check for errors and try again.