Early electroencephalographic findings in patients with anoxic encephalopathy after cardiopulmonary arrest and successful resusitation.
This study investigated whether or not early electroencephalographic (EEG) findings and brain computed tomographic (CT) features reflect the prognosis of comatose patients for 48 h after cardiopulmonary resuscitation (CPR). EEGs and brain CT scans were collected from 21 patients within 72 h after CPR. The EEG findings were classified according to the five Hockaday grades. The Glasgow outcome scale (GOS) applied 3 months after CPR was used for prognosis. Of the nine patients with grade 1 and 2 EEGs, eight had a good outcome (five recovered satisfactorily and three remained moderately disabled). Of the eight patients with grade 4 and 5 EEGs, seven had a poor outcome (three died and four remained in a persistent vegetative state). On the other hand, there was no correlation between early CT features and prognosis except for two severe cases, one whose gray/white matter interface had disappeared and the other with relatively increased density of the thalami, brain stem and cerebellum. These findings suggest that EEG is more useful than CT scan as a diagnostic tool for anoxic encephalopathy after CPR.
Ajisaka
Hideyuki
H
Department of Emergency and Critical Care Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. ajihide@med.kanazawa-u.ac.jp
D001921:Brain / Q000473:pathology / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004569:Electroencephalography; D023261:Glasgow Outcome Scale; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods