Reversible Akinetic Mutism after Aneurysmal Subarachnoid Haemorrhage in the Territory of the Anterior Cerebral Artery without Permanent Ischaemic Damage to Anterior Cingulate Gyri

Figure 4

MRI work-up (a-b) at acute phase and delayed (4 months) CT scanner follow-up imaging (c-d) of patient 2. (a) T2-weighted fast-spin echo (FSE) axial transverse view through cingulate gyri demonstrating oedema-related strong hypersignal intensity within them on both sides. Ventricular draining catheter is seen on right frontal area (dotted white arrow). (b) Axial transverse diffusion-weighted ( factor = 1000 s/mm²) view in similar slice location failed to reveal hypersignal intensity within the same cingular areas (black arrows), thereby excluding ischaemic cytotoxic oedema. Only false positive artifacts due to adjacent hematoma were seen (arrows). (c-d) CT scanner axial transverse (c) and coronal reformatted (d) images from helical acquisition demonstrating integrity of the cingulate gyri (arrows).

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