{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:29:15Z","timestamp":1790278155102,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T00:00:00Z","timestamp":1435881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Delayed posthypoxic leukoencephalopathy (<jats:styled-content style=\"fixed-case\">DPHL<\/jats:styled-content>) is a rare and underrecognized entity where patients manifest a neurological relapse after initial recovery from an acute hypoxic episode. We sought to describe the magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) findings in a group of patients with <jats:styled-content style=\"fixed-case\">DPHL<\/jats:styled-content> and review the available literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case series including patients who presented with neurological and\/or psychiatric symptoms after recovery from an acute hypoxic episode. The history and clinical presentation were reviewed from the electronic medical records. <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> scans were evaluated from the picture archiving and communication system. We performed a comprehensive review of the English medical literature for prior published cases of <jats:styled-content style=\"fixed-case\">DPHL<\/jats:styled-content> and describe the key imaging findings that have been reported related to this condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of five patients were identified, including four patients with respiratory failure due to drug overdoses from benzodiazepines, opioids, and\/or barbiturates, and one patient who presented after cardiopulmonary arrest due to pulmonary embolism. All patients showed diffuse, extensive, and confluent white matter signal abnormalities including prominent restricted diffusion, extending to the subcortical white matter and respecting the U\u2010fibers. There was no gyral edema or contrast enhancement. In one case histopathology was available, which highlighted patchy subcortical myelin loss with sparing of U\u2010fibers and demonstrated prominent macrophage\/microglial inflammation with extensive axonal damage. Of the other four patients, two were at their neurological baselines and two had persistent neurological deficits at the time of discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The described constellation of <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> findings is highly suggestive of <jats:styled-content style=\"fixed-case\">DPHL<\/jats:styled-content> in the appropriate clinical setting.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.364","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T17:59:21Z","timestamp":1435946361000},"source":"Crossref","is-referenced-by-count":76,"title":["Delayed posthypoxic leukoencephalopathy: a case series and review of the literature"],"prefix":"10.1002","volume":"5","author":[{"given":"Carlos A.","family":"Zamora","sequence":"first","affiliation":[{"name":"Division of Neuroradiology The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine 601\u00a0N Caroline St Baltimore MD 21287"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nauen","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine 600\u00a0N Caroline St Baltimore MD 21287"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hynecek","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine 601\u00a0N Caroline St Baltimore MD 21287"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet T.","family":"Ilica","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology The Russell H. 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