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A 46 year-old man was unresponsive after a cardiac arrest. Examination demonstrated extensor posturing and bilaterally dilated pupils.
CT scan of the brain: immediately after the event. Note that the scan is essentially normal. Anoxic injury is typically delayed and reaches a maximum at day 2 or 3. On the scan 2 days later, note the severe diffuse cerebral edema. No sulci are seen over the convexities and the ventricles and cisterns have been effaced. Also note the absence of the normal gray-white matter differentiation. Diffuse edema leads to increased intracranial pressure followed by decreased brain perfusion and then brain death.
The Electronic Curriculum is copyrighted 1998, Case Western Reserve University School of Medicine.