Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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May 11, 2009
Diffuse Cerebral Anoxia
- The dense or bright (AKA reversal sign) is the effect of anoxic/ischemic cerebral injury in children. It indicates serious, irreversible brain damage and carries a poor prognosis.
- There is diffuse decreased attenuation of the cerebral cortex with a relative preservation of density in the thalami, brainstem, and cerebellum.
- These findings have been described in abused children, birth asphyxia, anoxia due to drowning and neonatal hypothermia.
- Possible explanations include preserved brain tissue, petechial hemorrhage, and mineralized neurons for high-density areas on CT and severe edema and/or tissue destruction for low-density areas on CT.
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