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Updated: Oct 5, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
[Magnetic resonance imaging findings of postresuscitation encephalopathy: sequential change and correlation with
1Department of Neurosurgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki 710-0052, Japan.
Objective:
The purpose of this study was to describe the findings of sequential magnetic resonance imaging (MRI) in postresuscitation encephalopathy. Although its outcome is known to be overwhelming, but its acute findings by variable imaging methods are subtle and show only limited values. The correlation of the findings of MRI with clinical outcome were also analyzed.
Methods:
Twelve patients with global cerebral anoxia who underwent MRI with conventional and diffusion-weighted imaging were enrolled in this study. Compared with normal MRI images, abnormal signal regions were checked and described in cortex, basal ganglia and white matter. Also medical records were carefully reviewed to study the cause, the time necessary for resuscitation and long term clinical outcome.
Results:
The earliest finding was obtained by diffusion-weighted image less than 24 hours (acute period) in bilateral cerebral cortex as bright high signal intensity regions. Similar abnormality of bright high signal area in FLAIR and T 2 was followed according to the time elapsed in early subacute period (1-13 days). Succeedingly, white matter was involved and laminar necrosis in cortical area was observed in late subacute period (14-20 days). Finally, diffuse brain atrophy and obtundation of gray-white matter junction were seen in chronic stage (after 21 days). These MR findings were coincided well with histopathological findings reported in literatures. The poor outcome was closely and significantly correlated with abnormality in MR images.
Conclusion:
MRI was a useful diagnostic modality to diagnose the whole brain ischemic encephalopathy and to predict the prognosis.
Insights
Sequential magnetic resonance imaging (MRI) effectively detects changes in postresuscitation encephalopathy. MRI findings correlate significantly with clinical outcomes, aiding in prognosis prediction for global cerebral anoxia.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Context:
- Postresuscitation encephalopathy presents subtle acute findings with limited diagnostic value by conventional imaging.
- Global cerebral anoxia can lead to devastating neurological outcomes.
Purpose:
- To describe sequential magnetic resonance imaging (MRI) findings in postresuscitation encephalopathy.
- To analyze the correlation between MRI findings and clinical outcomes.
Summary:
- Diffusion-weighted imaging (DWI) detected earliest abnormalities in the cerebral cortex within 24 hours.
- Sequential MRI revealed evolving changes including white matter involvement, laminar necrosis, brain atrophy, and gray-white matter junction abnormalities.
- MRI findings correlated significantly with histopathological data and predicted poor clinical outcomes.
Impact:
- MRI serves as a valuable diagnostic tool for global ischemic encephalopathy.
- MRI aids in predicting the prognosis of patients with postresuscitation encephalopathy.
