Acute High-Altitude Cerebral Edema Presenting as Extensive Microbleeds along the Corpus Callosum without T2 Hyperintensity: A Case Report and Literature Review

손, 진영; 김, 지영; 임, 상혁

doi:10.3348/jksr.2020.0143

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…These atypical radiographic findings have also been reported in cases of HACE. [10,11] Vessel anatomy may potentially play a role in the development of CMBs of the corpus callosum. The presence of short perforating arteries from the pericallosal artery supplying the corpus callosum may make it prone to autoregulatory failure.…”

Section: Discussionmentioning

confidence: 99%

Critical illness-associated cerebral microbleeds involving the corpus callosum following cardiac arrest: A case report

Srichawla,

Fang,

Kipkorir

et al. 2024

Medicine

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Rationale: Critical illness-associated cerebral microbleeds (CI-aCMBs) are emerging as significant radiographic findings in patients with hypoxic ischemic injuries. Their occurrence, particularly in the corpus callosum, warrants a closer examination due to the potential implications for neurological outcomes in critically ill patients. We aim to describe a rare case of CI-aCMBs within the corpus callosum following cardiac arrest with the goal of bolstering the scientific literature on this topic. Patient concerns: A 34-year-old man with a history of polysubstance abuse was found unconscious and experienced a pulseless electrical activity (PEA) cardiac arrest after a suspected drug overdose. Post-resuscitation, the patient exhibited severe respiratory distress, acute kidney injury, and profound neurological deficits. Diagnoses: Initial magnetic resonance imaging scans post-cardiac arrest showed no acute brain abnormalities. However, subsequent imaging revealed extensive cerebral microbleeds predominantly in the corpus callosum, diagnosed as CI-aCMBs. These findings were made in the absence of high signal intensity on T2-weighted images, suggesting a unique pathophysiological profile of microhemorrhages. Interventions: The patient underwent targeted temperature management (TTM) and supportive care in the intensive care unit after cardiac arrest. Outcomes: He was subsequently extubated and had significant recovery without any neurological deficits. Lessons: CI-aCMBs is a rare radiographic finding after cardiac arrest. These lesions may be confined to the corpus callosum and the long-term clinical and radiographic sequelae are still largely unknown.

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Section: Discussionmentioning

confidence: 99%

Critical illness-associated cerebral microbleeds involving the corpus callosum following cardiac arrest: A case report

Srichawla,

Fang,

Kipkorir

et al. 2024

Medicine

View full text Add to dashboard Cite

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“…The effects of long-term exposure to high-altitude on brain structures in people with altitude sickness are now well established. People with altitude sickness entering highaltitude area may occur cerebral edema (43,44), cerebral hemorrhage (45)(46)(47), disruption of the integrity of the bloodbrain barrier (48,49), brain atrophy (50-52), and other structural changes in the brain. What about healthy people who are well adapted to the high-altitude environment?…”

Section: Discussionmentioning

confidence: 99%

“…The corpus callosum is the most important connection between the cortical areas of the brain in both hemispheres, connecting the fibers of motor, sensory and visual cortices ( 81 ). Studies have found that patients with acute plateau brain edema may present with multiple microhemorrhages along the corpus callosum ( 46 , 82 ) and iron heme deposits ( 83 ). In addition, transient bilateral visual loss associated with the corpus callosum can occur in people who acutely enter high-altitude areas ( 84 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of long-term exposure to high altitude on brain structure in healthy people: an MRI-based systematic review and meta-analysis

et al. 2023

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PurposeTo conduct a systematic review and meta-analysis of observational studies of brain MRI, this paper assesses the effects of long-term exposure to high-altitude on brain structures in healthy people.MethodsObservational studies related to high-altitude, brain and MRI were systematically searched based on data retrieved from PubMed, Embase and Cochrane Library. The timescale for collecting literature was from the establishment of the databases to 2023. NoteExpress 3.2 was used to manage the literature. Two investigators performed literature screening and data extraction based on inclusion criteria, exclusion criteria, and literature quality. The quality of the literature was assessed using the NOS Scale. Finally, meta-analysis of included studies was performed using Reviewer Manager 5.3.ResultsInitially, 3,626 articles were retrieved. After screening, 16 articles (n = 756 participants) were included in the systematic review, and meta-analysis was performed on 6 articles (n = 350 participants). The overall quality of the included articles was at medium level, with a mean NOS score of 5.62. The results of meta-analysis showed that the differences between the HA group and LA group were not statistically significant, in total GM volume (MD: −0.60, 95% CI: −16.78 to 15.58, P = 0.94), WM volume (MD: 3.05, 95% CI: −15.72 to 21.81, P = 0.75) and CSF volume (MD: 5.00, 95% CI: −11.10 to 21.09, P = 0.54).The differences between HA and LA in FA values of frontotemporal lobes were not statistically significant: right frontal lobe (MD: −0.02, 95% CI: −0.07 to 0.03, P = 0.38), left frontal lobe (MD: 0.01, 95% CI: −0.02 to 0.04, P = 0.65), right temporal lobe (MD: −0.00, 95% CI: −0.03 to 0.02, P = 0.78) and left temporal lobe (MD: −0.01, 95% CI: −0.04 to 0.02, P = 0.62). However, there were significant differences in GM volume, GM density and FA values in local brain regions between HA group and LA group.ConclusionCompared with LA area, there were no significant differences in total GM, WM and CSF volumes in healthy people living at high-altitude area for long-term, while there were significant differences in GM volume and FA values in local brain regions. Long-term exposure to high-altitude area caused the adaptive structural changes in local brain regions. Since heterogeneity existed between the studies, further studies are needed to uncover the effects of high-altitude on brain of healthy people.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42023403491.

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Acute High-Altitude Cerebral Edema Presenting as Extensive Microbleeds along the Corpus Callosum without T2 Hyperintensity: A Case Report and Literature Review

Cited by 2 publications

References 8 publications

Critical illness-associated cerebral microbleeds involving the corpus callosum following cardiac arrest: A case report

Critical illness-associated cerebral microbleeds involving the corpus callosum following cardiac arrest: A case report

Effects of long-term exposure to high altitude on brain structure in healthy people: an MRI-based systematic review and meta-analysis

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