REVERSAL SIGN ON CT - EFFECT OF ANOXIC ISCHEMIC CEREBRAL INJURY IN CHILDREN

被引:44
作者
HAN, BK
TOWBIN, RB
DECOURTENMYERS, G
MCLAURIN, RL
BALL, WS
机构
[1] CHILDRENS HOSP MED CTR, DEPT RADIOL, CINCINNATI, OH 45229 USA
[2] CHILDRENS HOSP MICHIGAN, DEPT RADIOL, DETROIT, MI 48201 USA
[3] UNIV CINCINNATI, COLL MED, DEPT PATHOL NEUROPATHOL, CINCINNATI, OH 45267 USA
[4] CHILDRENS HOSP MED CTR, DEPT SURG, NEUROSURG SECT, CINCINNATI, OH 45229 USA
关键词
D O I
10.2214/ajr.154.2.2105031
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
A retrospective study was performed to determine the clinical and pathologic features, etiology, and outcome of children with the reversal sign. The reversal sign, a striking CT finding, probably represents a diffuse, anoxic/ischemic cerebral injury. CT features of the reversal sign are diffusely decreased density of cerebral cortical gray and white matter with a decreased or lost gray/white matter interface, or reversal of the gray/white matter densities and relatively increased density of the thalami, brainstem, and cerebellum. Twenty children with the reversal sign were retrospectively analyzed. We divided the patients into three groups: (1) acute reversal, (2) intermediate group, and (3) chronic reversal. There were nine cases of trauma (seven of child abuse); nine hypoxia/anoxia incidents (birth asphyxia, drowning, status epilepticus); one bacterial meningitis; and one degenerative encephalitis. All acute- and intermediate-group patients had respiratory problems requiring ventilator support and intensive care. In five of seven patients who died, autopsy findings were consistent with anoxic/ischemic encephalopathy. Surviving patients have profound neurologic deficits with severe developmental delay. The CT reversal sign carries a poor prognosis and indicates irreversible brain damage.
引用
收藏
页码:361 / 368
页数:8
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