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.
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