PDF(Pubmed)
Abstract：
BACKGROUND: Critical illness-associated cerebral microbleeds (CI-aCMBs) are emerging as significant radiographic findings in patients with hypoxic ischemic injuries. Their occurrence, particularly in the corpus callosum, warrants a closer examination due to the potential implications for neurological outcomes in critically ill patients. We aim to describe a rare case of CI-aCMBs within the corpus callosum following cardiac arrest with the goal of bolstering the scientific literature on this topic.
METHODS: A 34-year-old man with a history of polysubstance abuse was found unconscious and experienced a pulseless electrical activity (PEA) cardiac arrest after a suspected drug overdose. Post-resuscitation, the patient exhibited severe respiratory distress, acute kidney injury, and profound neurological deficits.
METHODS: Initial magnetic resonance imaging scans post-cardiac arrest showed no acute brain abnormalities. However, subsequent imaging revealed extensive cerebral microbleeds predominantly in the corpus callosum, diagnosed as CI-aCMBs. These findings were made in the absence of high signal intensity on T2-weighted images, suggesting a unique pathophysiological profile of microhemorrhages.
METHODS: The patient underwent targeted temperature management (TTM) and supportive care in the intensive care unit after cardiac arrest.
RESULTS: He was subsequently extubated and had significant recovery without any neurological deficits.
CONCLUSIONS: CI-aCMBs is a rare radiographic finding after cardiac arrest. These lesions may be confined to the corpus callosum and the long-term clinical and radiographic sequelae are still largely unknown.
METHODS: A 34-year-old man with a history of polysubstance abuse was found unconscious and experienced a pulseless electrical activity (PEA) cardiac arrest after a suspected drug overdose. Post-resuscitation, the patient exhibited severe respiratory distress, acute kidney injury, and profound neurological deficits.
METHODS: Initial magnetic resonance imaging scans post-cardiac arrest showed no acute brain abnormalities. However, subsequent imaging revealed extensive cerebral microbleeds predominantly in the corpus callosum, diagnosed as CI-aCMBs. These findings were made in the absence of high signal intensity on T2-weighted images, suggesting a unique pathophysiological profile of microhemorrhages.
METHODS: The patient underwent targeted temperature management (TTM) and supportive care in the intensive care unit after cardiac arrest.
RESULTS: He was subsequently extubated and had significant recovery without any neurological deficits.
CONCLUSIONS: CI-aCMBs is a rare radiographic finding after cardiac arrest. These lesions may be confined to the corpus callosum and the long-term clinical and radiographic sequelae are still largely unknown.
摘要：
背景：危重病相关性脑微出血（CI-aCMBs）在缺氧缺血性损伤患者中作为重要的影像学表现正在出现。他们的发生，特别是在call体，由于对危重病患者神经系统预后的潜在影响，因此需要进行更仔细的检查。我们的目标是描述心脏骤停后call体内的CI-aCMBs罕见病例，目的是支持有关该主题的科学文献。
方法：一名34岁有多物质滥用史的男子被发现失去知觉，并在怀疑药物过量后经历了无脉性电活动（PEA）心脏骤停。复苏后,患者出现严重的呼吸窘迫,急性肾损伤，和严重的神经缺陷。
方法：心脏骤停后的初始磁共振成像扫描显示没有急性脑异常。然而,随后的成像显示广泛的脑微出血主要在call体，诊断为asCI-aCMBs。这些发现是在T2加权图像上没有高信号强度的情况下得出的，提示微出血的独特病理生理特征。
方法：患者在心脏骤停后在重症监护病房接受针对性体温管理（TTM）和支持治疗。
结果：患者随后拔管，恢复明显，无任何神经功能缺损。
结论：CI-aCMBs是心脏骤停后罕见的影像学表现。这些病变可能仅限于call体，长期的临床和影像学后遗症仍在很大程度上未知。
方法：一名34岁有多物质滥用史的男子被发现失去知觉，并在怀疑药物过量后经历了无脉性电活动（PEA）心脏骤停。复苏后,患者出现严重的呼吸窘迫,急性肾损伤，和严重的神经缺陷。
方法：心脏骤停后的初始磁共振成像扫描显示没有急性脑异常。然而,随后的成像显示广泛的脑微出血主要在call体，诊断为asCI-aCMBs。这些发现是在T2加权图像上没有高信号强度的情况下得出的，提示微出血的独特病理生理特征。
方法：患者在心脏骤停后在重症监护病房接受针对性体温管理（TTM）和支持治疗。
结果：患者随后拔管，恢复明显，无任何神经功能缺损。
结论：CI-aCMBs是心脏骤停后罕见的影像学表现。这些病变可能仅限于call体，长期的临床和影像学后遗症仍在很大程度上未知。
