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Case Reports
. 2022 Dec 26;16(1):480.
doi: 10.1186/s13256-022-03701-3.

Unilateral delayed post-hypoxic leukoencephalopathy: a case report

Johannes A R Pfaff  1 , Lukas Machegger  2 , Eugen Trinka  3   4   5   6 , Johannes Sebastian Mutzenbach  3
Affiliations
Case Reports

Unilateral delayed post-hypoxic leukoencephalopathy: a case report

Johannes A R Pfaff et al. J Med Case Rep. .

Abstract

Background: Delayed post-hypoxic leukoencephalopathy is a rare entity following hypoxia. Clinical and radiological signs of delayed post-hypoxic leukoencephalopathy have not previously been reported following acute ischemic stroke.

Case presentation: We report a case of an 81-year-old Central European man who presented with a dissection-related occlusion of the left carotid artery. He showed clinical improvement immediately after endovascular stroke therapy, followed by a significant clinical and especially cognitive deterioration thereafter and a clinical recovery after several weeks. The clinical course of the patient was accompanied by morphological changes on magnetic resonance imaging characteristic of delayed post-hypoxic leukoencephalopathy; that is, strictly limited and localized unilaterally to the left anterior circulation.

Conclusion: This case demonstrates that clinical symptoms and morphological changes on magnetic resonance imaging compatible with delayed post-hypoxic leukoencephalopathy do not necessarily only occur with global hypoxia, but can also occur in patients with a large vessel occlusion in the corresponding vascular territories.

Keywords: Carotid artery, internal, dissection; Case reports; Hypoxia-ischemia, brain; Ischemic stroke; Leukoencephalopathies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Diffusion-weighted imaging (DWI, top row), apparent diffusion coefficient (A, D, C, middle row) and fluid attenuated inversion recovery (FLAIR, bottom row) imaging at day 10 (A, D and G), day 23 (B, E and H), and day 92 (C, F and I) after endovascular recanalization of a left internal carotid artery occlusion. Please note the homogeneous white matter hyperintensity in the left anterior and middle cerebral artery territory on FLAIR images, which is not visible on day 10 (G), but on day 23 (H) and also on day 92 (I), sparing the subcortical U-fibers and with inconspicuous DWI at each corresponding MRI
See this image and copyright information in PMC

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