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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 Sparing the Brainstem                                        Show the Acute Ischemic Areas

Anoxic Encephalopathy (Diffuse Cerebral Edema): Diffusion-weighted MRIs of the brain: immediately after the event. Note that the entire cortical ribbon (right scan) and cerebellar hemispheres (left and middle scans) are infarcted. However, the brainstem remains intact. This is the classic picture of diffuse anoxia. If the patient survives, they remain in a persistent vegetative state (PVS). In PVS, there is complete destruction of the cortex with sparing of the brainstem.

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