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Regional Distribution of Brain Injury After Cardiac Arrest: Clinical and Electrographic Correlates

By Currents Editor posted 02-02-2022 09:48


Regional Distribution of Brain Injury After Cardiac Arrest: Clinical and Electrographic Correlates

Neurology (01/11/22) DOI: 10.1212/WNL.0000000000013301

Snider, Samuel B.; Fischer, David; McKeown, Morgan E; et al. 

Disorders of consciousness after cardiac arrest are linked with widely lower apparent diffusion coefficient (ADC) values on diffusion MRI, according to new research. The study, which provides Class IV evidence to that effect, also concluded the strongest associations with the disorders are with reductions in occipital ADC. For their research, the investigators evaluated 204 unresponsive patients who underwent diffusion MRI after cardiac arrest, classifying them based on recovery of consciousness prior to discharge, the most continuous EEG background, and whether there were seizures. When compared with 48 control subjects without cardiac arrest, the researchers found the cardiac arrest patients had most significant ADC signal reduction in their occipital lobes. Disorders of consciousness were linked to lower ADC most noticeably in the occipital lobes as well as in deep structures. Anoxic brain injury was most common in posterior cerebral regions, a regional pattern of injury that better served as a predictor of disorders of consciousness compared with whole-brain injury. Although EEG background suppression lacked specific regional association, seizures were less common in patients with injury to the temporal lobe. "Regional patterns of anoxic brain injury are relevant to the clinical and electrographic sequelae of cardiac arrest and may hold importance for prognosis," the researchers report.


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