Clinico-Radiological Dissociation in a Patient with Hypoxic Ischemic Encephalopathy

Abstract

Hypoxic-ischemic encephalopathy (HIE) is a frequent complication in the patients who survive a cardiac arrest. It has a very bad course of morbidity and mortality. Many patients with HIE needs neurorehabilitation for a long time, sometimes until death. Diagnostic tests of choice in adults with HIE are magnetic resonance imaging (MRI) and the severity correlates with the extent of the lesion in MRI. Normal MRI is very rarely seen in HIE. Here, we report a case of a 25-year-old male with ruptured liver abscess, who developed cardiopulmonary arrest on laparotomy table and was resuscitated immediately and kept on ventilator support for 4 days. The patient developed altered mentation since then and was evaluated for the same. His sepsis improved with treatment, but the altered mentation did not improve initially. MRI was done twice to look for findings of HIE, but they came out to be normal. Electro encephalogram was suggestive of global cerebral dysfunction with slow waves, that was suggestive of HIE. With continuous rehabilitation patient mentation improved slowly and he is slowly attaining complete recovery now.

Hypoxic-Ischemic Encephalopathy-Induced Seizure in an 11-Year-Old Female

“…HIE can also manifest in late childhood and adulthood. It arises in such cases due to global hypoperfusion due to cardiac arrest, drowning, or hypotension [ 5 ]. A retrospective study by Muttikkal et al showed that the prognosis of adults with HIE is relatively poor with only three patients in their study exhibiting signs of clinical improvement [ 6 ].…”