Concluded Case

Acute hypoxic ischemic encephalopathy with CNS Vasculitis.

New Case 37 yr ,F, known case of SLE,irregular treatment not following the medical opinion for 7 months,developed one episode of GTCs lasted for 10 mts ,followed by unconcious state for 3 days. on ventilator. On exam pupils 2 mm,poorly reacting . Ocular movements not full( sedated and medically paralised). Absent DTRs with 0 planters. MRI BRAIN done. Diagnosis & prognosis?

LikeAnswersShare
Concluded answer

Thanks for all answeres. MRI brain - Diffuse symmetrical T2/ FLAIR hyper intensities with diffuse cortical swelling and sulcal effacement noted in bilateral fronto temporo parietal cortices predominantly temporal cortex & deep grey matter( basal ganglia) with restricted diffusion and diffuse Leptomeningeal enhancement with out any blooming artifacts- Features consistent with ACUTE HYPOXIC ISCHEMIC ENCEPHALOPATHY. * Bilateraldistal cervical,petrous& cavernous segment of ICA appears normal in course & calibre with abrupt narrowing dismally with non- visualisation of supraclinoid & clinoid segments.M1 segment appears reduced in calibre bilaterally.Irregular luminal narrowing noted in the distal basilar artery and its branches - these features may indicate the diagnosis of vasculitis. Poor prognosis was explained to the relatives and they accepted the seriousness of illness. Despite ventilatory support and active managent,the Pt expired.

All Answers

Thanks for all answeres. MRI brain - Diffuse symmetrical T2/ FLAIR hyper intensities with diffuse cortical swelling and sulcal effacement noted in bilateral fronto temporo parietal cortices predominantly temporal cortex & deep grey matter( basal ganglia) with restricted diffusion and diffuse Leptomeningeal enhancement with out any blooming artifacts- Features consistent with ACUTE HYPOXIC ISCHEMIC ENCEPHALOPATHY. * Bilateraldistal cervical,petrous& cavernous segment of ICA appears normal in course & calibre with abrupt narrowing dismally with non- visualisation of supraclinoid & clinoid segments.M1 segment appears reduced in calibre bilaterally.Irregular luminal narrowing noted in the distal basilar artery and its branches - these features may indicate the diagnosis of vasculitis. Poor prognosis was explained to the relatives and they accepted the seriousness of illness. Despite ventilatory support and active managent,the Pt expired.

Probably autoimmune encephalitis due to SLE, NCSE Mri and mra appears normal to me

Only finding is HCP and nothing else..

Hydrocephalus

Thank you doctor
0

View 2 other replies

Cases that would interest you