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Key Image

Axial CT images of the head without contrast enhancement

Key Findings

Diffuse low density throughout the cerebral cortex with loss of normal sulci/gyri (red arrows) and grey-white differentiation (red circle). The right frontal horn of the lateral ventricles is slit-like (yellow arrow) due to compression from diffuse cerebral edema. There is a dense left MCA (blue arrow).

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Diagnosis

Diffuse Cerebral Edema
due to prolonged traumatic hypoxic event (aortic rupture)

Discussion

Diffuse Cerebral Edema is a result from severe cerebral ischemia / infarction. Massive brain swelling has a high mortality/morbidity rate.

Signs of Diffuse Cerebral Edema:
- loss / effacement of sulci, especially near the vertex.
- loss of gray-white matter differentiation
- loss of perimesencephalic cistern

References / Resources

Additional Information:

1. Dahnert*: 236-7
2. Primer*: 376
3. Related Article:

   Huang, BY "Hypoxic-Ischemic Brain Injury: Imaging Findings from Birth to Adulthood" Radiographics 2008: 28, 417-439.

   Kavanagn, EO "The Reversal Sign" Radiology 2007: 245, 914-915.

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