Reducing the Gray Zone: Imaging Spectrum of Hypoperfusion and Hypoxic Brain Injury in Adults

Overview

Journal Emerg Radiol

Specialties Emergency Medicine
Radiology

Date 2009 Jun 9

PMID 19504137

Citations 5

Authors

Matthew J Moore

Achala S Vagal

William M Strub

James L Leach

Affiliations

Soon will be listed here.

Abstract

The purpose of this pictorial essay is to illustrate the computed tomography and magnetic resonance imaging manifestations of hypoperfusion and hypoxic brain injury in adults, a clinical scenario not uncommon in the emergency room setting. The imaging findings can be subtle or marked depending on the type of injury and the time elapsed from injury to imaging. Accurate recognition of the imaging findings in hypoperfusion and hypoxic injury in adults is important for accurate therapy and family-patient counseling.

Citing Articles

Delayed brain injury post carbon monoxide poisoning.

Mazo J, Mukhtar E, Mazo Y, Nagaraj A, Mantello M Radiol Case Rep. 2020; 15(10):1845-1848.

PMID: 32802244 PMC: 7416690. DOI: 10.1016/j.radcr.2020.07.048.

Rare cerebellar lesions in a carbon monoxide poisoning case.

Zhu L, Zhou C, Wu J, Fang S Neurol Sci. 2013; 35(1):117-9.

PMID: 23864318 DOI: 10.1007/s10072-013-1506-6.

Cerebellar lesions in the acute setting of carbon monoxide poisoning.

Velioglu M, Gumus T, Husmen G Emerg Radiol. 2013; 20(3):255-7.

PMID: 23404410 DOI: 10.1007/s10140-013-1108-x.

Trainee misinterpretations on pediatric neuroimaging studies: classification, imaging analysis, and outcome assessment.

Guimaraes C, Leach J, Jones B AJNR Am J Neuroradiol. 2011; 32(9):1591-9.

PMID: 21835948 PMC: 7965384. DOI: 10.3174/ajnr.A2567.

CT and MR in non-neonatal hypoxic-ischemic encephalopathy: radiological findings with pathophysiological correlations.

Gutierrez L, Rovira A, Pezzi Portela L, da Costa Leite C, Lucato L Neuroradiology. 2010; 52(11):949-76.

PMID: 20585768 DOI: 10.1007/s00234-010-0728-z.

References

Arbelaez A, Castillo M, Mukherji S . Diffusion-weighted MR imaging of global cerebral anoxia. AJNR Am J Neuroradiol. 1999; 20(6):999-1007. PMC: 7056252. View

Given 2nd C, Burdette J, Elster A, Williams 3rd D . Pseudo-subarachnoid hemorrhage: a potential imaging pitfall associated with diffuse cerebral edema. AJNR Am J Neuroradiol. 2003; 24(2):254-6. PMC: 7974121. View

. Practice parameters for determining brain death in adults (summary statement). The Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 1995; 45(5):1012-4. DOI: 10.1212/wnl.45.5.1012. View

Singhal A, Topcuoglu M, Koroshetz W . Diffusion MRI in three types of anoxic encephalopathy. J Neurol Sci. 2002; 196(1-2):37-40. DOI: 10.1016/s0022-510x(02)00019-9. View

Wijdicks E, Campeau N, Miller G . MR imaging in comatose survivors of cardiac resuscitation. AJNR Am J Neuroradiol. 2001; 22(8):1561-5. PMC: 7974574. View

Kim J, Chang K, Song I, Kim K, Kwon B, Kim H . Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol. 2003; 24(8):1592-7. PMC: 7973971. View

Falini A, Barkovich A, Calabrese G, Origgi D, Triulzi F, Scotti G . Progressive brain failure after diffuse hypoxic ischemic brain injury: a serial MR and proton MR spectroscopic study. AJNR Am J Neuroradiol. 1998; 19(4):648-52. PMC: 8337410. View

Pantoni L, Garcia J, Gutierrez J . Cerebral white matter is highly vulnerable to ischemia. Stroke. 1996; 27(9):1641-6; discussion 1647. DOI: 10.1161/01.str.27.9.1641. View

Takahashi S, Higano S, Ishii K, Matsumoto K, Sakamoto K, Iwasaki Y . Hypoxic brain damage: cortical laminar necrosis and delayed changes in white matter at sequential MR imaging. Radiology. 1993; 189(2):449-56. DOI: 10.1148/radiology.189.2.8210374. View

10.

Kinoshita T, Sugihara S, Matsusue E, Fujii S, Ametani M, Ogawa T . Pallidoreticular damage in acute carbon monoxide poisoning: diffusion-weighted MR imaging findings. AJNR Am J Neuroradiol. 2005; 26(7):1845-8. PMC: 7975158. View

11.

Rubinstein D, Escott E, Kelly J . Methanol intoxication with putaminal and white matter necrosis: MR and CT findings. AJNR Am J Neuroradiol. 1995; 16(7):1492-4. PMC: 8338063. View

12.

Chalela J, Wolf R, Maldjian J, Kasner S . MRI identification of early white matter injury in anoxic-ischemic encephalopathy. Neurology. 2001; 56(4):481-5. DOI: 10.1212/wnl.56.4.481. View

13.

McKinney A, Teksam M, Felice R, Casey S, Cranford R, Truwit C . Diffusion-weighted imaging in the setting of diffuse cortical laminar necrosis and hypoxic-ischemic encephalopathy. AJNR Am J Neuroradiol. 2004; 25(10):1659-65. PMC: 8148705. View

14.

Kjos B, Brant-Zawadzki M, Young R . Early CT findings of global central nervous system hypoperfusion. AJR Am J Roentgenol. 1983; 141(6):1227-32. DOI: 10.2214/ajr.141.6.1227. View