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E2369. Hypoxic-Ischemic Brain Injury (HII) - Multimodality Imaging Spectrum From Birth to Adulthood: A Pictorial Review
Authors
  1. Mamta Gupta; Allegheny Health Network
  2. Warren Chang; Allegheny Health Network
  3. Charanjeet Singh; Allegheny Health Network
Background
Hypoxic-ischemic encephalopathy in adults and older children is also known as global hypoxic-ischemic injury (HII), is seen in many settings and often has devastating neurological sequelae. It can occur at any age, although the etiology is significantly different, for example - in older children, drowning and asphyxiation are the common causes and in adults, this is more often a result of cardiac arrest or cerebrovascular disease, with secondary hypoxemia/hypoperfusion.

Educational Goals / Teaching Points
To discuss mechanism and factors that influence patterns of injury in hypoxic-ischemic brain injury (HII). To identify the various US, CT, and MR imaging features of hypoxic-ischemic brain injury in different age group patients.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Mechanism and factors influencing the patterns of Injury in HII. Effect of patient’s age at the time of injury – Preterm Neonate, full term neonate, postnatal infants and young children and older children and adults. Degree of asphyxia – Mild, moderate and severe. Degree of brain involvement – partial or global. This presentation will expose you to many of the aforementioned but not limited to the classical such conditions through quiz-based (cases) and matching questions. For each of them, brief description, interpretation, imaging appearance, differential diagnosis and pitfalls will be described and teaching points/pearls will be made/highlighted.

Conclusion
To make the diagnosis of HII at CT, and MR imaging requires a clear understanding of the various imaging patterns that can result. By focusing on the specific regions that are most likely to be injured due to selective vulnerability, one can avoid false-negative interpretations. By understanding the different imaging patterns in the different phases may be helpful in determining the overall extent of injury and long-term prognosis, particularly in the pediatric population.