Status Epilepticus-Induced Hyperemia and Brain Tissue Hypoxia After Cardiac Arrest
Status Epilepticus-Induced Hyperemia and Brain Tissue Hypoxia After Cardiac Arrest
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DOI：
10.1001/archneurol.2011.240
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发表时间：
2011-10-01
影响因子：
--
通讯作者：
Mayer, Stephan A.
中科院分区：
文献类型：
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作者：
Ko, Sang-Bae;Ortega-Gutierrez, Santiago;Mayer, Stephan A.
目的：报道心脏骤停后癫痫持续状态患者脑血流及代谢的变化。设计：病例报道。背景：某大学附属医院神经重症监护室。患者：85岁，院外心脏骤停复苏后接受脑多模式监测和治疗。主要观察指标：脑血流和代谢的变化。结果：监测开始时检测到重复的脑电活动，脑组织氧分压显著降低，脑血流量和脑温度显著升高。静脉注射劳拉西坦和左乙拉西坦导致癫痫发作和相关的精神错乱立即停止。结论：脑多模式监测是评估心脏骤停后癫痫活动继发性脑损伤的一种可行的方法。
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.