Abstract
In two children with near drowning hypoxic encephalopathy and normal-appearing structural MRI, acute proton magnetic resonance spectroscopy ((1)H MRS) showed biochemical alterations that correctly indicated prognosis and helped to guide management decisions. Elevation of the lipid-lactate and glutamine-glutamate peaks, on the early (72 hour) (1)H MRS, predicts a poor prognosis. Absence of lipid-lactate and glutamine-glutamate peaks on the early (1)H MRS and reversibility of early mild metabolite abnormalities on follow up examination relates with good outcome.
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