Posterior periventricular extensive diffusion restriction in a 17 years old boy after cardiopulmonary resuscitation

Objectives: Defining the diffusion weighted MRI imaging findings in a child, after cardiopulmonary resuscitation. Methods: A 17 year old boy came to our emergency department becouse of a gunshot wound. During his follow-up at the intensive care unit, his unconsciousness remained despite the appropriate treatment. Cranial MRI is obtained. Results: Diffusion weighted cranial MRI revealed widespread diffusion restriction at the posterior periventricular areas consistent with postischemic injury. Unfortunately his clinical picture did not improved very much despite the appropriate treatment. Early after pediatric cardiac arrest, families and care providers struggle with the uncertainty of long-term neurological prognosis. Cardiac arrest characteristics such as location, intra-arrest factors, and postarrest events have been associated with outcome. Conclusion: In pediatric patients who remain comatose or have significant neurologic deficits after ardiopulmonary resuscitation, quantitative DWI MRI correlates with neurologic outcome. Methods used for the prediction of long-term neurological prognosis need to be specific enough to identify indivuals with a poor outcome. DWI has emerged as a potential predictor of recovery.
Keywords: trauma, cardiopulmonary resuscitation, ischemic injury, diffusion