History of cardiac arrest. Rule out hypoxic anoxic brain injury or hemorrhage. There are diffuse areas of cortical diffusion restriction involving the perirolandic regions, as well as the more posterior parietal and occipital cortices bilaterally. These are associated with cortical swelling and increased T2 signal. Similar cortical involvement is present in the mesial temporal lobes. Other areas of diffusion restriction are present in the corpus callosum, mid brain, pons, thalami, and putamina. The major arterial and venous flow voids are grossly intact. The parenchymal abnormalities would be compatible with a severe type of hypoxic ischemic injury. There is no associated intracranial hemorrhage. There is no midline shift, but the cerebellar tonsils are mildly low-lying. The ventricles are normal in size and symmetric. The orbits, skull and scalp soft tissues are grossly unremarkable. There are scattered sinonasal secretions and mucosal thickening, as well as minimal fluid in the mastoid air cells, which may be related to intubation.
Widespread cortical diffusion restriction with additional involvement of the deep gray nuclei as well as the brainstem is compatible with severe hypoxic ischemic injury without hemorrhagic transformation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.