• Bahadar S Srichawla, Ton Fang, Vincent Kipkorir, and Rakhee Lalla.
• Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA.
• Medicine (Baltimore). 2024 Aug 9; 103 (32): e39273e39273.

RationaleCritical illness-associated cerebral microbleeds (CI-aCMBs) are emerging as significant radiographic findings in patients with hypoxic ischemic injuries. Their occurrence, particularly in the corpus callosum, warrants a closer examination due to the potential implications for neurological outcomes in critically ill patients. We aim to describe a rare case of CI-aCMBs within the corpus callosum following cardiac arrest with the goal of bolstering the scientific literature on this topic.Patient ConcernsA 34-year-old man with a history of polysubstance abuse was found unconscious and experienced a pulseless electrical activity (PEA) cardiac arrest after a suspected drug overdose. Post-resuscitation, the patient exhibited severe respiratory distress, acute kidney injury, and profound neurological deficits.DiagnosesInitial magnetic resonance imaging scans post-cardiac arrest showed no acute brain abnormalities. However, subsequent imaging revealed extensive cerebral microbleeds predominantly in the corpus callosum, diagnosed as CI-aCMBs. These findings were made in the absence of high signal intensity on T2-weighted images, suggesting a unique pathophysiological profile of microhemorrhages.InterventionsThe patient underwent targeted temperature management (TTM) and supportive care in the intensive care unit after cardiac arrest.OutcomesHe was subsequently extubated and had significant recovery without any neurological deficits.LessonsCI-aCMBs is a rare radiographic finding after cardiac arrest. These lesions may be confined to the corpus callosum and the long-term clinical and radiographic sequelae are still largely unknown.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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