Reversible hypoxic brain injury: the penumbra conundrum of Grinker

BMJ Case Rep. 2019 Apr 23;12(4):e228670. doi: 10.1136/bcr-2018-228670.

Abstract

A female patient, aged 61 years, presented to us with a 3-day history of fever and altered sensorium. She was discharged from another hospital 1 week back where she was admitted for community-acquired pneumonia. She was put on mechanical ventilation for threatened airway and her magnetic resonance brain imaging showed evidence of delayed posthypoxic leucoencephalopathy, also known as Grinker's myelinopathy. She was discharged 1 month later, on room air with a tracheostomy tube in situ. On follow-up after 5 months, she was ambulating with support and carried out activities of daily living independently.

Keywords: clinical neurophysiology; neuroimaging.

Publication types

  • Case Reports

MeSH terms

  • Activities of Daily Living
  • Aftercare
  • Brain / diagnostic imaging
  • Brain / pathology
  • Community-Acquired Infections / complications
  • Female
  • Humans
  • Hypoxia, Brain / diagnostic imaging*
  • Hypoxia, Brain / etiology
  • Leukoencephalopathies / diagnostic imaging*
  • Leukoencephalopathies / pathology
  • Leukoencephalopathies / therapy
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / diagnosis
  • Pneumonia / therapy*
  • Rare Diseases
  • Respiration, Artificial / adverse effects*
  • Tracheostomy / methods
  • Treatment Outcome