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[Hypoxic encephalopathy with quadriplegia and cortical blindness]
N Kasahata1, M Kawamura, J Shiota
1Department of Neurology, Ushioda General Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|October 1, 1994
Summary
A patient developed quadriplegia and cortical blindness after shock and mild hypoperfusion. This case highlights selective brain lesions in hypoxic encephalopathy, particularly affecting motor and visual cortices.
Area of Science:
- Neuroscience
- Neurology
- Clinical Medicine
Background:
- Hypoxic encephalopathy can lead to severe neurological deficits.
- Selective brain injury patterns are crucial for understanding prognosis.
Observation:
- A 63-year-old woman experienced shock after antipyretic administration, leading to coma.
- She later regained consciousness with quadriplegia and cortical blindness.
- Neurological exam revealed Anton sign, geotropic ocular deviation, and bilateral pyramidal signs.
Findings:
- Brain MRI showed high-intensity signals in bilateral precentral and calcarine cortices.
- This pattern suggests mild hypoperfusion as the cause of hypoxia.
- Literature review identified similar cases with selective lesions in these areas due to oligemic hypoxia.
Implications:
- This case expands the understanding of hypoxic brain injury patterns.
- Selective cortical lesions can result in specific neurological deficits like quadriplegia and cortical blindness.
- Further research into the mechanisms of selective neuronal vulnerability in hypoxia is warranted.