Diagnosis: Cardiac arrest, cause unspecifiedClinical question: s/p PEA arrest, assess brain parenchyma for hypoxic changesSigns and Symptoms: as above There is gyral T2 and FLAIR hyperintensity along small portions of the left posterior temporal lobe and left inferior parietal lobule associated with the blood products. There is a small amount of extra-axial blood present adjacent to the left and right parietal lobes and to a lesser degree right frontal lobe.A small focus of diffusion restriction is present along the left insular cortex.A punctate focus of diffusion weighted imaging signal hyperintensity without restriction is present in the left cerebellar hemisphere.At T2 and FLAIR hyperintense focus is present along the medial aspect of the left cerebellar hemisphere measuring 8 mm in diameter. This was not previously present.Punctate foci of T1 signal hyperintensity associated with susceptibility effect are present in the cerebellar hemispheres. There is also a punctate focus of signal loss on susceptibility imaging along the left lingual gyrus which was also present on the prior MRI exam and likely represents an old microhemorrhage. In isolation is of little clinical significance.There are 5-10 periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These are stable compared to prior examNormal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate some mucosal thickening in the maxillary sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Small hemorrhagic foci are present along the left inferior parietal lobule and left posterior temporal lobe. The cause is unknown based on this exam. One possibility is that this represents hemorrhagic conversion of prior infarction.2.A small focus of subacute infarction is present in the left insular cortex3.Small foci of extra-axial blood are present adjacent to the parietal lobes and right frontal lobe4.There are new microhemorrhages present in the cerebellar hemispheres one of which displays a small amount of adjacent cerebellar edema.5.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 