Maayke Hunfeld

156 Chapter 5 Normal brain MRI findings were associated with good outcome with a negative predictive value (NPV) of 85%, reflecting 2 children with poor neurological outcome despite a normal brain MRI (both PCPC =3 at hospital discharge). Good neurological outcome two years post-OHCA In 13/18 children with good outcome, brain MRI did not show brain injury. Focal injury was found in 5 children, including 1 child with poor neurological outcome at discharge (PCPC 3), who improved to PCPC 2 two years post-OHCA. Two other children with poor neurological outcome at hospital discharge (both PCPC= 3) improved to good neurological outcome 2 years post-OHCA (both PCPC=2); they had normal brain MRI studies. Normal brain MRI findings were strongly associated with good outcome with a NPV of 100% (Table 3). MRI of the brain at the level of the basal ganglia with axial T2-weighted sequences (A, D), diffusion-weighted imaging (B, E) and matching ADC maps (C, F) of two different patients. Patient 1 (A, B, C) shows hyperintense T2 signal and diffuse swelling of the cortex of all the cerebral lobes and the basal ganglia (A) with corresponding restricted diffusion in the affected areas (B, C) (extensive cortex/white matter injury). Patient 2 (D, E, F) demonstrates hyperintense T2 signal of the basal ganglia and thalami and focal swelling of the cortex of the occipital lobes (D) with corresponding restricted diffusion in the affected areas (E, F) (focal cortex/white matter injury with deep grey matter involvement).