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Updated: Nov 1, 2025

High-resolution Structural Magnetic Resonance Imaging of the Human Subcortex In Vivo and Postmortem
Published on: December 30, 2015
Delayed cerebral enhancement on post-mortem computed tomography due to residual contrast medium administered shortly
Naomasa Okimoto1, Masanori Ishida1, Hiroyuki Abe2
1Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Abstract:
Postmortem computed tomography (CT) is currently a well-known procedure and helps in postmortem investigations. In this case report, we report a unique postmortem CT finding: delayed cerebral enhancement associated with the antemortem infusion of contrast medium. A 72-year-old female lost consciousness at a restaurant and was taken to a hospital in an ambulance. Despite resuscitation efforts, she died of hypoxic-ischemic encephalopathy caused by cardiac arrest. About 6 h before her death, she underwent enhanced antemortem CT of the head. No abnormal enhancement was observed in the cerebral parenchyma. Then, 11 h after her death, she underwent unenhanced postmortem CT, which showed bilateral hyperdense caudate nucleus and putamina, due to residual iodinated contrast medium, in addition to other characteristic findings of hypoxic-ischemic encephalopathy. The mechanism underlying this phenomenon could be the destruction of the blood-brain barrier, and/or selective vulnerability, due to hypoxic-ischemic changes in the gray matter. Enhancement of basal ganglia on postmortem CT due to antemortem infusion of iodinated contrast medium might suggest hypoxic-ischemic encephalopathy, which should be noted in postmortem CT interpretations.
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