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J Neurocrit Care 2009;2(1): 33-35.
A Case of Unilateral Hypoxic Cerebral Injury: Contribution of Underlying Vascular Occlusion and Degree of Hypoxia
Young-Ho Koo, MD, Dong-Gun Kim, MD, Hyun-Sook Kim, MD, Won-Chan Kim, MD, Ok-Joon Kim, MD and Seung-Hun Oh, MD
Department of Neurology, Pochon CHA University College of Medicine, Seongnam, Korea
ABSTRACT
Background: Cerebral cortex is extremely prone to hypoxia. Cerebral injury usually develops bilaterally in hypoxia. We report a case with unilateral hypoxic brain damage after pure hypoxia.
Case Report: A case developed stuporous mentality and left hemiplegia after respiratory arrest due to a massive hemoptysis. A brain diffusion-weighted image (DWI) revealed the pan-hemispheric cortical and basal ganglia lesion only in the right side. A brain CT angiography exhibited complete occlusion of ipsilateral proximal internal carotid artery (ICA). There was hyperperfusion at the DWI lesion site on Tc-99m-HMPAO-SPECT scan.
Conclusions: Unilateral cerebral injury is a rare condition in pure hypoxia. The combined effect of underlying hemodynamic insufficiency due to ICA occlusion and hypoxic insult results in an unilateral distribution of cerebral lesion in this case.
Key Words: Hypoxia·Cerebral injury·Unilateral·Cortical laminar necrosis
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