Khot Sandeep, Tirschwell David L
Department of Neurology, University of Washington, Seattle, Washington, USA.
Semin Neurol. 2006 Sep;26(4):422-31. doi: 10.1055/s-2006-948323.
Hypoxic-ischemic encephalopathy accompanying cardiac arrest is a common cause of long-term neurological dysfunction. With the improvement in prehospital emergency systems, larger numbers of people are resuscitated from cardiac arrests, although with the increased prospect of neurological sequelae. Neurological impairment after cardiac arrest is dependent on the degree of brain damage suffered during the arrest. Although the duration and severity of brain ischemia is often difficult to determine, clinicians are often faced with difficult issues related to predicting outcome related to awakening and long-term neurological deficits after the arrest. Neurological impairments range from mild cognitive deficits to severe motor and cognitive deficits that preclude independence in many activities of daily living. Several neurological syndromes have been described in patients who awaken from hypoxic-ischemic coma with lasting motor and cognitive deficits. This review will address many of the common syndromes after hypoxic-ischemic encephalopathy, including persistent vegetative states, seizures, myoclonus, movement disorders, cognitive dysfunction, and other neurological abnormalities.
心脏骤停伴发的缺氧缺血性脑病是长期神经功能障碍的常见原因。随着院前急救系统的改善，越来越多的人从心脏骤停中复苏过来，尽管出现神经后遗症的可能性增加了。心脏骤停后的神经损伤取决于骤停期间所遭受的脑损伤程度。虽然脑缺血的持续时间和严重程度往往难以确定，但临床医生常常面临与预测心脏骤停后苏醒及长期神经功能缺损相关结果有关的难题。神经损伤范围从轻度认知缺陷到严重的运动和认知缺陷，后者使许多日常生活活动无法独立完成。在从缺氧缺血性昏迷中苏醒但伴有持续性运动和认知缺陷的患者中，已描述了几种神经综合征。本综述将探讨缺氧缺血性脑病后的许多常见综合征，包括持续性植物状态、癫痫发作、肌阵挛、运动障碍、认知功能障碍及其他神经异常。
