The tale of global hypoxic ischaemic injury

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

C-0400

Type:

Educational Exhibit

Keywords:

CNS, CT, MR, Education, Computer Applications-Detection, diagnosis, Imaging sequences, Acute, Ischaemia / Infarction

Authors:

L. M. Zammit¹, R. Grech²; ¹Paola/MT, ²Dublin 9/IE

DOI:

10.1594/ecr2016/C-0400

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/C-0400

Fig. 1: DWI MR, at 24 hours: Cortical laminar necrosis.

Fig. 2: DWI MR, at 48 hours: Cortical laminar necrosis. Gray matter and basal ganglia...

Fig. 3: Flair MR, at 24 hours: Cortical swelling.

Fig. 4: FLAIR MR, at 48 hours: Cortical swelling.

Learning objectives

To determine the timely radiological features of global hypoxic ischaemic injury To assess hypoxic-ischaemic brain injury in different radiological windows of Ct and MRI scanning To interpret changing radiological features in the light of clinical examination

Background

Definition Global hypoxic ischaemia injury can affect the neonates, older children and adults. It is secondary to an underlying cause and typically presents with a deterioration in conscious level as scored on the Glasgow Coma Scale. It can be accompanied by clinical features related to its cause, typical biochemical derangements , often metabolic acidosis, and imaging. Pathophysiology HI-BI occurs when combined low oxygen tensions and limited blood supply are delivered to the brain. This results in cellular energy failure and neuronal death. Grey matter ,...

Findings and procedure details

Conclusion

There are characteristic radiological changes on CT and MRI in global hypoxic ischaemic injury. Magnetic resonance imaging provides better quality images of selective tissue injury in the brain. Changes can be followed through sequential scanning. They can potentially be used to assess response to pharmacological and interventional therapies.

Personal information

L. M. Zammit, Foundation doctor, Year 2, Mater Dei Hospital, Malta, EU. R. Grech, Consultant Radiologist, Medical Imaging Department, Mater Dei Hospital, Malta, EU.

References

Medical Imaging Department, Mater Dei Hospital, Malta. EU. Anderson, C. A. and D. B. Arciniegas (2010). "Cognitive sequelae of hypoxic-ischemic brain injury: a review."NeuroRehabilitation26(1): 47-63. Lu-Emerson, C. and S. Khot (2010). "Neurological sequelae of hypoxic-ischemic brain injury."NeuroRehabilitation26(1): 35-45. Calvert, J. W. and J. H. Zhang (2005). "Pathophysiology of an hypoxic-ischemic insult during the perinatal period."Neurological Research27(3): 246-260. Busl, K. M. and D. M. Greer (2010). "Hypoxic-ischemic brain injury: pathophysiology, neuropathology and mechanisms."NeuroRehabilitation26(1): 5-13. http://radiopaedia.org/articles/hypoxic-ischaemic-brain-injury-1