Ex-FT female with cardiac arrest on DOL 1 (was down 90 mins), vEEG shows activity concerning for a hypoxic ischemic episode. There are scattered areas of high T1 signal in the cerebral cortex, particularly involving the bilateral perirolandic regions, bilateral hippocampi, bilateral posterior cingulate gyri, and left insula. There is also prominent T1 signal in the bilateral basal ganglia. There is deficiency of white matter T1 hyperintensity in the posterior limbs of the internal capsules and perirolandic regions. There is a punctate focus of susceptibility effect in the left occipital horn. There is high T1 signal and restricted diffusion in the bilateral transverse sinuses. There is no evidence of acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Findings compatible with subacute hypoxic ischemic injury in a central and peripheral distribution with delayed myelination.2. Findings suggestive of dural venous thrombosis involving the bilateral transverse sinuses versus flow artifact. An MRV may be useful fir further evaluation.3. Punctate blood products in the left lateral ventricle.Discussed with Dr. Jaideep Singh at 4 PM on 9/28/15.