Hypoxic Brain Injury Following Drug Packet Rupture

drug packets

This young adult male patient collapsed on an international flight.
A cerebral CT was performed for ongoing reduced level of consciousness.
An abdominal CT was performed.

The radiological findings are:

  • Bilateral globus pallidus hypodensity consistent with hypoxic brain injury.
  • Rounded heterogeneous structures in stomach and bowel (drug packets).
  • The “knot sign” – an eccentric low density nodule on the drug packet, representing the knot in the condom.
  • These findings together suggest drug packet rupture followed by collapse, hypoxia and subsequent brain injury.

    Credit: Dr Laughlin Dawes