‘Reversal sign’ CT - Global hypoxia

Despite major advances in monitoring technology and knowledge of fetal and neonatal pathology, perinatal asphyxia / hypoxic-ischemic encephalopathy (HIE), remains major cause of mortality and morbidity.
Reversal sign’ on CT is a diffusely decreased density of cerebral cortical gray and white matter, loss of gray white matter interface, relatively hyper dense cerebellum due to preserved density, represents a Global hypoxia.
The CT reversal sign carries a poor prognosis and indicates irreversible brain damage.
Surviving patients have profound neurological deficits with severe developmental delay.