Bilateral Cranial Tc-99m Mdp Uptake due to Hypoxic-ischemic Encephalopathy

Abstract: A 50-year-old man with lung cancer had an episode of suffocation due to abrupt massive hemoptysis. He was resuscitated in the emergency room, but became unconscious thereafter. A CT scan of the head revealed no intracranial calcifications or calvarial destruction. An MRI of the brain showed cortical signal intensity in the bilateral frontal, parietal, occipital and right temporal lobes consistent with hypoxic-ischemic encephalopathy. Following gadolinium injection, MR images show cortical enhancement following a laminar distribution in the watershed territories. Staging for osseous metastases with Tc-99m MDP bone scan revealed abnormal tracer uptake in both frontal, parietal, occipital, and right temporal lobes.