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Washington University Experience | VASCULAR | Infarct - Acute | 3A0 Case 3 History
Case 3 History ---- The patient was a 4 year old girl with a history of complex congenital heart disease characterized by double outlet right ventricle with subpulmonic ventricular septal defect (Taussig-Bing anomaly) and side-by-side great vessels. Over the four years of her life she had 4 major cardiac surgeries, several “minor” non-OR surgeries and 4 episodes necessitating ECMO. During her final hospitalization (beginning 1/15), she was noted to have asymmetric pupils and was taken to the CT scanner on an emergent basis. The CT scan revealed multiple regions of low attenuation throughout the cerebrum in the watershed areas as well as in the cerebellum consistent with multiple infarcts. She continued to be hypotensive with multiple organ dysfunction and her family decided to withdraw support. She died on 1/16. ---- At autopsy the unfixed brain weighed 1200g. The brain showed bilateral acute infarcts heterogeneously involving the watersheds between anterior, middle and posterior cerebral arteries.
