A 76 yo male brought unconscious to Neuro ICU.
Diffusion weighted images of brain show foci of recent ischemia in left insular cortex and splenium of corpus callosum. Previous Echo report mentions poor cardiac status and proneness for embolism which explains embolic infarct in left insular cortex. But the infarct involving splenium of corpus callosum is due to cardiac arrest and hypotension as on admission his BP was very low.
Infarct involving splenium of corpus callosum are very rare and known to occur in cardiac arrest and hypotension.
DDs for restricted diffusion in Splenium of Corpus Callosum:
Ischemia - Embolism, Cardiac arrest, Hypotension.
Epilepsy patients - A reversible signal abnormality as a part Post ictal odema and due to long term use of Anti epileptic drug (AEDs) and is found to be reversible after discontinuation of AEDs.
Encephalitis - Milder form of viral encephalitis like Influenza.
Diffuse axonal injury - Trauma.
Multiple sclerosis - plaques of Demyelination, often associated with similar lesion elsewhere.
Marchiafava Bignami disease - Alcoholic, Malnurished patients.
Wernicke's encephalopathy - Alcoholic, Malnurished patients, Any major bowel surgery.
DDs for restricted diffusion in Splenium of Corpus Callosum:
Ischemia - Embolism, Cardiac arrest, Hypotension.
Epilepsy patients - A reversible signal abnormality as a part Post ictal odema and due to long term use of Anti epileptic drug (AEDs) and is found to be reversible after discontinuation of AEDs.
Encephalitis - Milder form of viral encephalitis like Influenza.
Diffuse axonal injury - Trauma.
Multiple sclerosis - plaques of Demyelination, often associated with similar lesion elsewhere.
Marchiafava Bignami disease - Alcoholic, Malnurished patients.
Wernicke's encephalopathy - Alcoholic, Malnurished patients, Any major bowel surgery.
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