Abstract
A 56-year-old male was brought to our emergency department because of self-inflicted stab wounds, six hours after injury. His consciousness was clear and vital signs were stable on admission. There were multiple stab wounds reaching the thorax and abdominal cavity. Emergency thoracostomy, laparotomy, and hemostasis were performed. On hospital day 4, after extubation, neurological examination revealed mild disturbance of his speech and difficulty moving the fingers of his right hand. Head MRI revealed a high-intensity signal lesion at the bilateral basal ganglia on DWI, FLAIR, and T2-weighted images. An ADC map showed decreased intensity at the corresponding area. SPECT (99mTc-ECD) revealed mean cerebral blood flow (mCBF) of 44ml/100 g/min and decreased regional CBF in the left basal ganglia. On follow-up MRI and CT, the ischemic lesion remained. This case was diagnosed as hypoxic ischemic encephalopathy due to the loss of blood because of multiple wounds without obvious hemorrhagic shock.
