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Serial diffusion-weighted MR Imaging in delayed postanoxic encephalopathy. A case study.

H Y Kim1, B J Kim, S Y Moon

  • 1Departments of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 ILwon-dong Kangnam-ku Seoul, 135-710, Korea.

Journal of Neuroradiology = Journal De Neuroradiologie
|November 26, 2002
PubMed
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Delayed postanoxic encephalopathy (DPE) shows evolving diffusion changes over one year. Serial diffusion-weighted imaging reveals initial low apparent diffusion coefficient (ADC) values in white matter, gradually normalizing, suggesting cytotoxic edema from hypoxia-induced apoptosis.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Delayed postanoxic encephalopathy (DPE) is a rare neurological condition following hypoxic-ischemic injury.
  • Understanding the temporal evolution of DPE is crucial for diagnosis and management.

Observation:

  • Serial diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping were performed five times over one year in a DPE case.
  • ADC values of periventricular white matter were initially reduced at 3 and 7 weeks post-insult.
  • ADC values progressively normalized over 4, 6, and 12 months.

Findings:

  • The serial ADC changes observed in this case are consistent with cytotoxic edema.
  • Hypoxia-induced apoptosis is a potential pathogenetic mechanism contributing to these observed changes.

Related Experiment Videos

  • The normalization of ADC values indicates a resolution of cytotoxic edema over time.

    • Implications:

    • Serial DWI and ADC mapping can track the evolution of DPE.
    • These findings support the role of apoptosis in the pathogenesis of DPE.
    • This case highlights the dynamic nature of DPE and its potential for recovery as indicated by imaging biomarkers.