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Logo of bmcneulBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Neurology
BMC Neurol. 2007; 7: 18.
Published online Jun 27, 2007. doi:  10.1186/1471-2377-7-18
PMCID: PMC1925116
Pyramidal and extrapyramidal dysfunction as a sequela of hypoxic injury: case report
Martina Vendramecorresponding author1 and S Ausim Azizi1
1Department of Neurology, Temple University School of Medicine, Philadelphia, USA
corresponding authorCorresponding author.
Martina Vendrame: vendrame/at/; S Ausim Azizi: azizia/at/
Received November 17, 2006; Accepted June 27, 2007.
The clinical and radiological aspects of hypoxic brain injury without ischemia are not well characterized. A spectrum of clinical manifestations have been observed in patients that recover from hypoxic brain injury, including a subset that demonstrate persistent motor system disturbances. Early Magnetic Resonance Imaging (MRI) studies have shown abnormalities in basal ganglia, cerebral and cerebellar cortex.
Case presentation
A 23-year-old man was affected by acute respiratory failure after drug overdose. His clinical condition progressed from coma to partial recovery with persistent lack of control and stiffness in the lower extremities. MRI of the brain showed evolving lesions in the cerebellum, globus pallidus and motor cortex that correlated with neurological signs.
A careful analysis of this case and a review of the relevant literature indicate that the clinical residua after recovery from hypoxic injury to the brain is predominantly disorders of the motor system, and the MRI manifestations as well as the clinical presentation can evolve over time. Understanding more of the factors that affect hypoxic brain injury can be helpful in determining the clinical outcome and management of these patients.
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