Male, 21 months old, unresponsive, with loss of most brainstem reflexes, breathing over the vent. Assess degree of neurologic injury after prolonged cardiac arrest. Diffuse abnormal cortical and subcortical T2/FLAIR hyperintensity is seen within the cerebral hemispheres, the basal ganglia, cerebellum and to a lesser degree the brainstem. Note is also made of diffuse extensive cortical T1 hyperintensity particularly involving the basal ganglia and the cortex of the posterior frontal lobes, parietal lobes, occipital and temporal lobes. No clear restricted diffusion is seen.There may be trace scattered parenchymal susceptibility suggesting a small amount of hemosiderin deposition. Note is made of small bilateral parietal and occipital extra-axial collections which demonstrate T1 hyperintensity. The sulci and ventricles have widened compared to prior CT examinations.
Sequelae of extensive hypoxic ischemic injury are demonstrated including diffuse abnormal T2/FLAIR signal and cortical T1 hyperintensity suggesting laminar necrosis. The cerebral hemispheres, deep gray nuclei, cerebellum and to a lesser degree the brainstem are all involved.Since prior CTs, the sulci and ventricles have widened which may represent a combination of resolving edema and loss of parenchymal volume.Note is made of small subacute likely subdural hematomas along the bilateral parietal and occipital lobes.