Portal de Periódicos da CAPES

Status Epilepticus–Induced Hyperemia and Brain Tissue Hypoxia After Cardiac Arrest

2011; American Medical Association; Volume: 68; Issue: 10 Linguagem: Inglês

10.1001/archneurol.2011.240

1538-3687

Sang‐Bae Ko, Santiago Ortega‐Gutiérrez, H. Alex Choi, Jan Claassen, Mary Presciutti, J. Michael Schmidt, Neeraj Badjatia, Kiwon Lee, Stephan A. Mayer,

Epilepsy research and treatment

Objective To report changes of cerebral blood flow and metabolism associated with status epilepticus after cardiac arrest. Design Case report. Setting Neurological intensive care unit in a university hospital. Patient An 85-year-old man resuscitated from out-of-hospital cardiac arrest underwent brain multimodality monitoring and treatment with therapeutic hypothermia. Main Outcome Measures 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. Conclusion Brain multimodality monitoring is a feasible method for evaluating secondary brain injury associated with seizure activity after cardiac arrest.