Hypoxic-ischemic brain injury

Case contributed by Eric F Greif
Diagnosis certain

Presentation

History of cardiac arrest.

Patient Data

Age: 80 years
Gender: Female

CT Brain

ct

There is complete reversal of gray and white matter densities with the basal ganglia,
thalami and cortex being hypodense compared to the hyperdense white matter. There is also partial effacement of the cortical sulci. Findings are compatible with diffuse cerebral edema secondary to anoxic/ischemic cerebral injury.

Case Discussion

80 year old female status post cardiac arrest. The head CT demonstrates true reversal of the gray and white matter, keeping with hypoxic-ischemic brain injury. In a normal head CT, the gray matter is white and the white matter is grey. Take a second look at the case and appreciate the true reversal sign. Patient died a few days after the CT scan.      

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