Hypoxic–Ischemic brain injury in an adult: Magnetic Resonance Imaging findings

Maurya, Vinay; Ravikumar, R.; Bhatia, Mukul; Rai, Roma

doi:10.1016/j.mjafi.2015.06.016

Cited by 7 publications

(6 citation statements)

References 4 publications

(4 reference statements)

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“…During this early subacute phase (24 h-2 weeks), injured grey matter structures show T2 hyperintensity and swelling [5][6][7]. Gyrifom enhancement of the injured cortex may be seen in this phase [8,9]. In the chronic stage, T1 hyperintense changes of cortical necrosis are seen along with residual T2 hyperintensity and gliosis in the basal ganglia [5].…”

Section: Haemodynamic Alterations: Hypoxic-ischaemic Encephalopathymentioning

confidence: 99%

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

2020

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Gyriform restricted diffusion (GRD) refers to hyperintense signal involving the cerebral cortex on diffusion-weighted images (DWI) with corresponding hypointensity on apparent diffusion coefficient (ADC) images. These changes are commonly seen following a vascular occlusion, reflecting the limitation of water molecule movement across cell membranes (restricted diffusion) due to the failure of Na + /K + -ATPase pumps (cytotoxic oedema). However, GRD can occur in several other neurological conditions as well. A thorough understanding of these conditions and their anatomic predilection plays a critical role in identifying and differentiating them from vascular thrombo-occlusion, with impact towards appropriate clinical management. This review highlights the less commonly encountered, non-stroke causes of GRD in adults with case-based examples. A tabulated chart of the patterns of cortical and subcortical involvement associated with these aetiologies is provided for a quick, pattern-based reference for daily radiological reporting.

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Section: Haemodynamic Alterations: Hypoxic-ischaemic Encephalopathymentioning

confidence: 99%

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

2020

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“…Magnetic resonance findings in hypoxic ischemic brain injury (HIBI) depend on the duration, severity of insult and 1-4] EEG: Back ground activity of theta waves (5-6 HZ, 10-20 mv) distributed symmetrically in both hemispheresuggestive of generalized cerebral dysfunction [Figure 5] time period after which MRI is performed. [4] In adults, mild-to-moderate HIBI leads to watershed infarcts. Severe HIBI affects gray matter of the peri rolandic cortical neurons, occipital cortex, medial prefrontal cortex, basal ganglia, thalami, hippocampus, and cerebellum.…”

Section: Discussionmentioning

confidence: 99%

“…Contrast enhancement gyri form pattern is usually seen in such cases after 1-2 weeks, peaks after 1-2 months, and commonly resolves after 6 months. [4] However, in some cases, MRI can come out to be normal; with clinical and electrophysiological evidence of HIE.…”

Section: Discussionmentioning

confidence: 99%

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Clinico-Radiological Dissociation in a Patient with Hypoxic Ischemic Encephalopathy

Mukundan¹,

Sethi²,

Meena³

et al. 2021

JMSH

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Hypoxic-ischemic encephalopathy (HIE) is a frequent complication in the patients who survive a cardiac arrest. It has a very bad course of morbidity and mortality. Many patients with HIE needs neurorehabilitation for a long time, sometimes until death. Diagnostic tests of choice in adults with HIE are magnetic resonance imaging (MRI) and the severity correlates with the extent of the lesion in MRI. Normal MRI is very rarely seen in HIE. Here, we report a case of a 25-year-old male with ruptured liver abscess, who developed cardiopulmonary arrest on laparotomy table and was resuscitated immediately and kept on ventilator support for 4 days. The patient developed altered mentation since then and was evaluated for the same. His sepsis improved with treatment, but the altered mentation did not improve initially. MRI was done twice to look for findings of HIE, but they came out to be normal. Electro encephalogram was suggestive of global cerebral dysfunction with slow waves, that was suggestive of HIE. With continuous rehabilitation patient mentation improved slowly and he is slowly attaining complete recovery now.

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“…HIE is currently evaluated with multimodality imaging, including magnetic resonance imaging (MRI) with T1-/T2-weighted imaging (T1WI/T2WI) ( 7 ), diffusion-weighted imaging (DWI) ( 8 ), diffusion tensor imaging (DTI) ( 9 , 10 ), magnetic resonance spectroscopy ( 4 ), and arterial spin labeling (ASL) ( 11 ), and other modalities such as contrast-enhanced ultrasound ( 12 ). ASL is a noninvasive perfusion imaging technique that can assess regional cerebral blood flow (CBF) by magnetically labeling inflowing blood.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Pulsed Arterial Spin Labeling Perfusion Weighted Imaging Predicts Language and Motor Outcomes in Neonatal Hypoxic-Ischemic Encephalopathy

et al. 2020

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Rationale and Objectives: To compare cerebral pulsed arterial spin labeling (PASL) perfusion among controls, hypoxic ischemic encephalopathy (HIE) neonates with normal conventional MRI(HIE/MRI⊕), and HIE neonates with abnormal conventional MRI(HIE/MRI⊖). To create a predictive machine learning model of neurodevelopmental outcomes using cerebral PASL perfusion. Materials and Methods: A total of 73 full-term neonates were evaluated. The cerebral perfusion values were compared by permutation test to identify brain regions with significant perfusion changes among 18 controls, 40 HIE/MRI⊖ patients, and 15 HIE/MRI⊕ patients. A machine learning model was developed to predict neurodevelopmental outcomes using the averaged perfusion in those identified brain regions. Results: Significantly decreased PASL perfusion in HIE/MRI⊖ group, when compared with controls, were found in the anterior corona radiata, caudate, superior frontal gyrus, precentral gyrus. Both significantly increased and decreased cerebral perfusion changes were detected in HIE/MRI⊕ group, when compared with HIE/MRI⊖ group. There were no significant perfusion differences in the cerebellum, brainstem and deep structures of thalamus, putamen, and globus pallidus among the three groups. The machine learning model demonstrated significant correlation (p < 0.05) in predicting language(r = 0.48) and motor(r = 0.57) outcomes in HIE/MRI⊖ patients, and predicting language(r = 0.76), and motor(r = 0.53) outcomes in an additional group combining HIE/MRI⊖ and HIE/MRI⊕. Conclusion: Perfusion MRI can play an essential role in detecting HIE regardless of findings on conventional MRI and predicting language and motor outcomes in HIE survivors. The perfusion changes may also reveal important insights into the reperfusion response and intrinsic autoregulatory mechanisms. Zheng et al. Outcome Prediction in Neonatal HIE Our results suggest that perfusion imaging may be a useful adjunct to conventional MRI in the evaluation of HIE in clinical practice.

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Hypoxic–Ischemic brain injury in an adult: Magnetic Resonance Imaging findings

Cited by 7 publications

References 4 publications

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

Gyriform restricted diffusion in adults: looking beyond thrombo-occlusions

Clinico-Radiological Dissociation in a Patient with Hypoxic Ischemic Encephalopathy

Cerebral Pulsed Arterial Spin Labeling Perfusion Weighted Imaging Predicts Language and Motor Outcomes in Neonatal Hypoxic-Ischemic Encephalopathy

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