Hypoxic ischemic injury

Case contributed by Dr Amro Omar


Comatosed patient, history of anaphylactic shock.

Patient Data

Age: 45

First MRI study

DWI shows increased signal in cerebellar hemispheres, basal ganglia, and cerebral cortex. These changes are subtle in FLAIR sequence.


One month later

  • T1WI shows BG hyperintensity and cortical pseudolaminar necrosis
  • FLAIR shows symmetric hyperintensity in deep gray nuclei and cortex

  • DWI is less restricted

Case Discussion

In hypoxic ischemic injury DWI is the first imaging sequence to become positive, within hours after HII event. Grey matter is highly vulnerable due to high energy demands.

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Case information

rID: 35084
Published: 27th Apr 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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