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Hemorrhagic infarct of basal ganglia in cardiac arrest. CT and MRI findings. 2 cases
Affiliations- Medical and Toxicological Intensive Care Unit, Assistance Publique – Hôpitaux de Paris, Groupe Hospitalier Lariboisière – Saint Louis, Paris, France
- Université Paris Sorbonne Cité, Paris Diderot, Paris, France
- UMR-8536, Université Paris Descartes, Paris, France
- INSERM U1144, Paris, France
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Abstract
We report the CT and MRI findings in two cases of hemorrhagic infarct of the basal ganglia (BG), following out-of-hospital cardiac arrest (CA).
In case 1, Brain-CT realized at day 2 showed bilateral and almost symmetric hemorrhagic infarct of the BG and infarct of the tectum of the mesencephalon. In case 2, MRI realized at day 6 showed hemorrhagic infarct of both lenticular nuclei on T2 GE images.
In both cases there was no medical history and the cardiovascular and the coagulation profile were normal.
In these cases, the lesions are observed earlier than reported in a few previous radiological cases. Similar lesions have been reported in pathological studies.
These lesions seem occur early after CA. Reperfusion is probably responsible for the hemorrhagic transformation. The reason why some patients present either BG or brainstem infarct or both remains unclear.
Bilateral and symmetric hemorrhagic infarct of the BG, especially of the Lenticular nuclei, and infarct of the dorsal pons and mesencephalic tegmentum seem to be a characteristic feature of profound and prolonged hypotension or of CA.
Abstract
We report the CT and MRI findings in two cases of hemorrhagic infarct of the basal ganglia (BG), following out-of-hospital cardiac arrest (CA).
In case 1, Brain-CT realized at day 2 showed bilateral and almost symmetric hemorrhagic infarct of the BG and infarct of the tectum of the mesencephalon. In case 2, MRI realized at day 6 showed hemorrhagic infarct of both lenticular nuclei on T2 GE images.
In both cases there was no medical history and the cardiovascular and the coagulation profile were normal.
In these cases, the lesions are observed earlier than reported in a few previous radiological cases. Similar lesions have been reported in pathological studies.
These lesions seem occur early after CA. Reperfusion is probably responsible for the hemorrhagic transformation. The reason why some patients present either BG or brainstem infarct or both remains unclear.
Bilateral and symmetric hemorrhagic infarct of the BG, especially of the Lenticular nuclei, and infarct of the dorsal pons and mesencephalic tegmentum seem to be a characteristic feature of profound and prolonged hypotension or of CA.
Keywords
Basal ganglia, Cerebral Hemorrhage, Hemorrhagic infarct, Cardiac arrest, MRI, Brain-CT
About this articleTitle
Hemorrhagic infarct of basal ganglia in cardiac arrest. CT and MRI findings. 2 cases
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
94-97
Published online
2017-09-21
Page views
474
Article views/downloads
890
DOI
10.1016/j.pjnns.2017.09.004
Bibliographic record
Neurol Neurochir Pol 2018;52(1):94-97.
Keywords
Basal ganglia
Cerebral Hemorrhage
Hemorrhagic infarct
Cardiac arrest
MRI
Brain-CT
Authors
Monique Boukobza
Frédéric J. Baud
