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Anoxia - Case 4

A 52 year-old man developed a massive gastrointestinal bleed followed by hypotension and a subsequent cardiac arrest. Following the arrest, he was in a coma. However, all of his brainstem reflexes were intact.

Note the Effaced Basal Cisterns                                    Note the Effaced Sulci over the Convexities

Anoxic Encephalopathy (Diffuse Cerebral Edema): Axial CT scans 2 days after the event. Note the severe diffuse cerebral edema. No sulci are seen over the convexities and the ventricles and cisterns have been effaced. Also note the absence of the normal gray-white matter differentiation. This radiographic picture is most often seen following trauma, hypoxia (as in this case) or CNS infection, especially meningitis. In this scenario, the diffuse edema leads to increased intracranial pressure followed by decreased brain perfusion and subsequent brain death.

Revised 11/23/06
Copyrighted 2006. David C Preston