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September 1987

Bilateral Basal Ganglia Necrosis Following Diffuse Hypoxic-lschemic Injury

Author Affiliations

Department of Neurology University of Utah Medical Center 500 N Medical Dr Salt Lake City, UT 84132

Arch Neurol. 1987;44(9):897. doi:10.1001/archneur.1987.00520210005003

To the Editor.  —In the July 1986 issue of the Archives, Helgason et al1 demonstrated the computed tomographic features of infarcts in the anterior choroidal artery territory, which typically included a part of the posterior limb of the internal capsule. The subject is of interest to us, because Lindenberg2 proposed anterior choroidal artery compression as a mechanism of basal ganglia necrosis secondary to global hypoxic-ischemic injury. Computed tomographic-neuroanatomic correlations were made for five clinical cases. Cases 1 through 3 suffered cardiorespiratory arrest and case 4, carbon monoxide intoxication. Hydrogen sulfide inhalation was responsible for case 5.3 Computed tomographic lesions were defined by a neuroradiologist who was not provided with a clinical history and compared with normal cadaver brain slices cut at the same angle as the computed tomographic scan. The lucent basal ganglia lesions were symmetric, varied in size, and spared the internal capsule (Figure). Case 1

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