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Abstract

Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.

B K Han, R B Towbin, G De Courten-Myers, R L McLaurin and W S Ball
American Journal of Neuroradiology November 1989, 10 (6) 1191-1198;
B K Han
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
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R B Towbin
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
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G De Courten-Myers
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
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R L McLaurin
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
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W S Ball Jr
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229.
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Abstract

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.

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American Journal of Neuroradiology
Vol. 10, Issue 6
1 Nov 1989
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Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.
B K Han, R B Towbin, G De Courten-Myers, R L McLaurin, W S Ball
American Journal of Neuroradiology Nov 1989, 10 (6) 1191-1198;

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Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children.
B K Han, R B Towbin, G De Courten-Myers, R L McLaurin, W S Ball
American Journal of Neuroradiology Nov 1989, 10 (6) 1191-1198;
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