Fig. 16.

59-year-old man with COVID-19 respiratory failure requiring a prolonged intensive care unit stay of 18 days complicated by acute kidney injury requiring hemodialysis and Klebsiella and Pseudomonas bacteremia. He had a poor mental status when he was weaned off sedation due to anoxic brain injury and herniation. (a, b) Axial non-contrast CT images show diffuse loss of gray white differentiation and effacement of cerebral sulci compatible with global anoxic injury. There is (a) subarachnoid hemorrhage (arrow) and (b) brainstem hemorrhage (arrow). (c) Sagittal non-contrast head CT image demonstrates loss of gray white differentiation, cerebral edema, and resultant transtentorial herniation with foci of duret hemorrhage (arrow) in the brainstem.