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Hypoxic- Ischemic Encephalopathy
- Causes in adults:
- Cardiac arrest
- Cerebrovascular accident
- Selectively vulnerable areas of the brain: For detailed pathophysiology cascade click here
- Areas with highest concentrations of glutamate or other excitatory amino acid receptors
- Areas of the brain with greatest energy demands.
- Mild to moderate ischemic insult: Watershed territory infarcts.
- Severe ischemic insult:
- Basal ganglia and thalami.
- Cerebral cortex
- Changes seen earliest on DWI (few hours) as areas of restricted diffusion.
- T2W images positive in early subacute period (24 hours–2 weeks),
- DWI can pseudonormalize by the end of the 1st week while T2W abnormalities persist.
- Outcome is relatively poor.
|Imaging findings associated with relatively better outcome:||Imaging findings associated with relatively poor outcome:|
- Imaging algorithm:Click here