CT SCAN ABNORMALITIES IN A SERIES OF PATIENTS WITH HEMORRHAGIC-SHOCK AND ENCEPHALOPATHY SYNDROME

Background Hemorrhagic shock and encephalopathy syndrome (HSES) affect s children under 1 year of age and is characterized by seizures, shock and certain laboratory abnormalities, including coagulation abnormali ties, It has a high mortality and many of the survivors are neurologic ally abnormal. Objective. To describe abnormalities observed on initia l and follow-up CT scans in a group of patients suffering from HSES. M aterials and methods. Retrospective review of records and CT scans of ten patients with HSES who were admitted to the intensive care unit of the Children's Hospital and Medical Center, Seattle. Results. Cerebra l edema was seen in all cases when the CT scan was obtained between 1 and 7 days after onset of HSES. The basal ganglia and cerebellum were relatively spared, and no hemorrhage was seen. Patients with moderate or marked cerebral edema usually had a poor prognosis, All survivors h ad significant neurologic sequelae. CT scans obtained after 7 days oft en showed encephalomalacia with ex vacuo ventricular enlargement. CT s cans obtained between 24 h and 4 days after onset will show the acute changes of HSES. CT scans during the initial and convalescent stages o f HSES can provide useful information about cerebral edema and encepha lomalacia, which occur frequently with this illness.