Cardiac arrest [427.5], Reason for Study: ^Reason: eval for ischemic injury History: altered mental status There are multifocal bihemispheric subtle restricted diffusion areas including bilateral basal ganglia, bilateral caudate nucleus head, bilateral occipital lobes and bilateral mesial thalami indicating diffuse hypoxic injury.There are high signal intensity lesion on FLAIR and T2 weighted images on the pons without involving cortical surface of pons which may indicate associated osmotic demyelination such as central pontine myelinolysis. Correlation of the patient's history especially electrolyte level would help in differential diagnosis.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses are clear.Bilateral mastoid air cells are opacified.
1. Multifocal restricted diffusion lesions indicating acute ischemic infarction on bilateral basal ganglia, mesial thalami, caudate nucleus, parietal lobes and occipital lobes. The distribution of lesions are compatible with global hypoxic injury.2. Relatively well demarcated high signal intensity lesions on pons with sparing cortical surface indicate possibility of osmotic demyelination.