Post-hypoxic early selective putaminal necrosis followed by delayed extensive sub-cortical demyelination.
OBJECTIVE
To describe the patterns of early and delayed hypoxic damage to the brain parenchyma.


METHODS
This paper reports a case with interesting clinical course and MRI brain changes in a patient following a single hypoxic-anoxic exposure after an alcoholic binge.


RESULTS
Bilaterally symmetrical putaminal necrosis was noted in the initial MRI, but subsequent follow-up revealed extensive demyelination of the sub-cortical white matter, associated with the clinical deterioration.


CONCLUSIONS
The brain, in general, and the neurons in caudate nucleus, putamen, globus pallidus and cerebral white matter, in particular, are susceptible to hypoxic injury. These changes may occur simultaneously and early or sequentially and late.
Sharma
Vijay K
VK
Division of Neurology, National University Hospital, Singapore. drvijay@singnet.com.sg
Tan
June H
JH
D000328:Adult; D003711:Demyelinating Diseases / Q000175:diagnosis / Q000209:etiology*; D018450:Disease Progression; D000431:Ethanol / Q000506:poisoning*; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology; D018458:Persistent Vegetative State / Q000209:etiology; D011699:Putamen / Q000473:pathology*
D000431:Ethanol