title: Status epilepticus-induced hyperemia and brain tissue hypoxia after cardiac arrest.
abstract: OBJECTIVE
  To report changes of cerebral blood flow and metabolism associated with status epilepticus after cardiac arrest.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Neurological intensive care unit in a university hospital.
  
  
  METHODS
  An 85-year-old man resuscitated from out-of-hospital cardiac arrest underwent brain multimodality monitoring and treatment with therapeutic hypothermia.
  
  
  METHODS
  Changes of cerebral blood flow and metabolism.
  
  
  RESULTS
  Repetitive electrographic seizure activity detected at the start of monitoring was associated with dramatic reductions in brain tissue oxygen tension and striking surges in cerebral blood flow and brain temperature. Intravenous lorazepam and levetiracetam administration resulted in immediate cessation of the seizures and these associated derangements. The lactate to pyruvate ratio was initially elevated and trended down after administration of anticonvulsants.
  
  
  CONCLUSIONS
  Brain multimodality monitoring is a feasible method for evaluating secondary brain injury associated with seizure activity after cardiac arrest.
authors: Neurological Intensive Care Unit, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
authors: Sang-Bae
authors: SB
authors: Ko
authors: Santiago
authors: S
authors: Ortega-Gutierrez
authors: H Alex
authors: HA
authors: Choi
authors: Jan
authors: J
authors: Claassen
authors: Mary
authors: M
authors: Presciutti
authors: J Michael
authors: JM
authors: Schmidt
authors: Neeraj
authors: N
authors: Badjatia
authors: Kiwon
authors: K
authors: Lee
authors: Stephan A
authors: SA
authors: Mayer
mesh_terms: D000369:Aged, 80 and over; D001831:Body Temperature; D001921:Brain / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D004569:Electroencephalography; D006801:Humans; D006940:Hyperemia / Q000209:etiology*; D007036:Hypothermia, Induced / Q000379:methods; D002534:Hypoxia, Brain / Q000209:etiology*; D007275:Injections, Intravenous / Q000379:methods; D007427:Intracranial Pressure; D000077287:Levetiracetam; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications* / Q000628:therapy; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives; D013226:Status Epilepticus / Q000150:complications* / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000077287:Levetiracetam; D008140:Lorazepam; D010889:Piracetam