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Washington University Experience | VASCULAR | Infarct, watershed | 4A0 Case 4 History
Case 4 History ---- The patient was a 74 year old woman with a past medical history of hypertension, diabetes and multiple urinary tract infections. The patient had appropriate neurological function until she was admitted on 9/20 in diabetic ketoacidosis. During that admission she suffered a period of hypoperfusion and bradycardia requiring aggressive resuscitation. The patient did not return to her neurological baseline once her metabolic derangements were corrected. Head CT on 9/24 and brain MRI on 9/27 showed diffuse brain atrophy and bilateral cerebral and cerebellar border zone infarcts. The patient remained oriented only to self and required nursing home care until final hospitalization for hematuria and melena in February 2008. She underwent ileocolectomy to remove the source of bleeding, but continued to have severe blood loss and the patient passed away on 2/13.
