DYNAMIC BRAIN MAGNETIC RESONANCE IMAGING OF DROWNING VICTIUM WITH HYPOXIC DAMAGE

Abstract

In most countries, drowning is one of the three leading causes of children’s death from 5 and 14 years of age, and the most common cause with children under the age of 4 [1–3]. Drowning makes 7% of all fatal accidents involving similar types of brain damage among all age groups worldwide.

The aim. To show the importance of brain magnetic resonance studies of a patient with hypoxic-ischemic lesion during the acute period. An attempt to predict the outcome after global brain hypoxia in a little boy.

Materials and methods. A 2-year-old boy was examined with a dynamic brain MRI after drowning.

Results. Brain MRI made 30 minutes later after drowning showed bilateral matter hyperintensity from the parietal lobes, posterior frontal lobes, hippocampus, right lenticular nucleus, ventral tegmentum of the brainstem on the diffusion-weighted imaging (DWI). A lower diffusion coefficient on Apparent diffusion coefficient (ADC) maps reveals intracellular (cytotoxic) edema caused by acute hypoxic damage. At follow-up after 15 days — T2-weighted image shows white matter hyperintensity. The expansion of the ventricular system, the subarachnoid space of the large hemispheres reflects diffuse cerebral atrophy.

Conclusion. Physicians need revealing the vastness of hypoxic brain damage and reliable criteria to predict the outcome of the disease. Diffusion-weighted magnetic resonance imaging provides a sensitive measure of cerebral hypoxia and provides a reliable prediction of the outcome of drowning.