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Journal of Pediatric Neurology 2010; 08(02): 231-235
DOI: 10.3233/JPN-2010-0397
Georg Thieme Verlag KG Stuttgart – New York

Failure of diffusion weighted MRI to detect severe hypoxic-ischemic encephalopathy in a child

Autoren

  • Thilinie Rajapakse

    a   Division of Pediatric Neurology, University of Calgary, Calgary, AB, Canada

  • Vijay Ramaswamy

    b   Division of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada

  • James Scozzafava

    c   Division of Critical Care Medicine, University of Calgary, Calgary, AB, Canada

  • D. Barry Sinclair

    b   Division of Pediatric Neurology, University of Alberta, Edmonton, AB, Canada

Verantwortlicher Herausgeber dieser Rubrik:
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Publikationsverlauf

05. März 2008

12. Mai 2009

Publikationsdatum:
30. Juli 2015 (online)

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Abstract

Diffusion weighted imaging is currently the standard of care in the early imaging of hypoxic-ischemic brain injury. Its use has been well described in adults; however, there is a paucity of data regarding its use and reliability in the immature brain. Here we report a case of a 17-month-old who died from a diffuse hypoxic ischemic injury secondary to asphyxiation where there was a failure of diffusion-weighted imaging to show diffuse injury. The electroencephalogram, neurological examination and computerized tomography all suggested global hypoxic-ischemic injury, yet the diffusion weighted imaging showed only focal ischemia at 48 hours post injury. We discuss possible mechanisms underlying the failure of diffusion-weighted imaging to provide an accurate measure of the severity of this child's injury, and highlight the importance of the neurological examination in determination of prognosis in hypoxic-ischemic brain injury.

Keywords

Hypoxic-ischemic brain injury - diffusion weighted imaging - ischemia - neurological outcome