Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score.
10.4266/kjccm.2015.30.4.265
- Author:
Woo Sung CHOI
;
Jin Joo KIM
;
Hyuk Jun YANG
- Publication Type:Original Article
- Keywords:
magnetic resonance imaging;
outcome;
out-of-hospital cardiac arrest;
therapeutic hypothermia
- MeSH:
Basal Ganglia;
Brain*;
Cerebellum;
Cerebral Cortex;
Emergencies;
Hand;
Humans;
Hypoxia-Ischemia, Brain;
Intensive Care Units;
Magnetic Resonance Imaging*;
Neuroimaging;
Out-of-Hospital Cardiac Arrest*;
Putamen;
Retrospective Studies;
Survivors
- From:Korean Journal of Critical Care Medicine
2015;30(4):265-271
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center. METHODS: Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status. RESULTS: Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients' B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum. CONCLUSIONS: Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
