Background
Case presentation
Neuropsychological test | Results | |
---|---|---|
1st
|
2nd
| |
Digit span: forward/backward | 6/3 | 8/5 |
Letter cancellation, vigilance test | NL | NL |
Fluency | Fluent | Fluent |
Comprehension/repetition/reading/writing | NL/NL/NL/NL | NL/NL/NL/NL |
K-BNT | 51/60 | 49/60* |
Calculation | 11/12 | 11/12 |
Finger naming/R.-L. orientation/body part identification/praxis | NL/NL/NL/NL | NL/NL/NL/NL |
Interlocking pentagon | NL | NL |
Rey Complex Figure Test copy | 36/36 | 33/36 |
SVLT free recall/delayed recall | 8(2 + 3 + 3)*/0* | 13(5 + 3 + 5)*/4* |
RCFT immediate recall, 20-min delayed recall | 0/36*, 0/36* | 3/36*, 0/36* |
Semantic word fluency: animals/supermarket items | 4/6* | 6/5* |
Phonemic word fluency: ㄱ/ㅅ/ㅇ | 3/1/4* | 5/4/5* |
Stroop test: word/color | 112/45* | 112/78* |
Trail making test: part A/part B | 17s/30s | 12s/25s |
Digit symbol coding | 46* | 57* |
MMSE | 18/30 | 23/30 |
CGA-NPI | 16/144 | 37/144 |
FBI | 26/72 | 39/72 |
Discussion and conclusions
Toxic encephalopathy | Acute hypoxic-ischemic encephalopathy | Delayed hypoxic-ischemic encephalopathy | |
---|---|---|---|
Etiology | Drugs of abuse (e.g. Butane, Heroin) | Cardiac arrest Acute respiratory insufficiency Other toxic causes (e.g., CO) | Cardiorespiratory compromise Other toxic causes |
MRI findings | - High FLAIR or T2 signal intensities in the thalamus, basal ganglia, cerebellum, or insula (Butane intoxication) - High signal changes in the putamen, and occipital and frontal lobes in DWI (Butane intoxication) - Symmetrically increased T2 and FLAIR signal intensity of the cerebellar and posterior cerebral white matter, posterior limb of the internal capsule with sparing of the anterior limb of the internal capsule and dentate nuclei (Heroin inhalation) | - Diffuse cortical injury on DWI - Border zone distribution of ischemia - Increased T2 and FLAIR signal intensity in the globus pallidus along with corresponding diffusion restriction - Much less commonly increased T2 and FLAIR signal intensity in the caudate, putamen, thalamus, hippocampus, cerebellum, and brain stem than that in the globus pallidus | - High T2-FLAIR signal intensity in the periventricular white matter and centrum semiovale sparing the cerebellum and the brainstem tracts |
Reference | [24] |