Age inconsistent brain atrophy following post cardiac arrest brain injury (PCABI): case report and review of literature

Introduction and importance: Age-inconsistent brain atrophy refers to brain shrinkage that is not proportional to chronological age. This case report is first to report a young patient who developed age-inconsistent brain atrophy due to post cardiac arrest brain injury (PCABI). Due to limitations in the available data, we report our experience and novel magnetic resonance (MR) imaging changes in the brain over the course of 2 months. Case presentation: We report a case of a 28-year-old woman who developed sudden cardiac arrest during a routine cesarean section, with loss of consciousness for an unspecified period of time. She was resuscitated, intubated and later transferred to intensive care unit (ICU); where her Glasgow Coma Scale on arrival was 4/15. Detailed history, physical examination, and radiological investigations confirmed the diagnosis of PCABI. She was treated in ICU along with physiotherapy for speedy recovery. Clinical discussion: PCABI is the major cause of long-term disability and mortality following cardiac arrest. In this novel case report, we establish that it can lead to age-inconsistent brain atrophy. Conclusion: Serial MR imaging scans of the brain should be performed for suspected or confirmed PCABI to evaluate brain atrophy and other changes. This will not only aid in deciphering residual brain deficits but also help in guiding the correct management of the patients.