Multiple Brain Hemorrhages in a Patient Treated for Smoke Inhalation

A 47-year-old male, with no background illnesses, was injured by smoke inhalation after trying to save a neighbor’s son from a burning apartment. Upon his arrival at the hospital, he was conscious and alert, but suffered from severe shortness of breath.

The patient underwent intubation and was treated with 100% oxygen. A day after his arrival, a chest X-ray showed ARDS.

After one week on artificial ventilation, an attempt to wean the patient from intubation was performed but has failed both respiratory and neurologically.

The patient was agitated and did not communicate or cooperate with the treating staff.

Unenhanced CT and MRI of the head revealed countless foci of bleeding scattered all over the brain, mainly subcortical, sparing the basal ganglia.

In this presentation we will describe the imaging findings during his hospitalization.

The possible pathophysiological basis for this condition and the differential diagnoses will be discussed.