Nguyen Maxime, Bièvre Thomas, Nadji Abdelouaid, Bouhemad Bélaïd
Department of Anesthesiology and Intensive Care, C.H.U. Dijon, Dijon Cedex, France.
Université Bourgogne Franche-Comté, LNC UMR866, 21000 Dijon, France.
Case Rep Crit Care. 2018 Jul 19;2018:2709174. doi: 10.1155/2018/2709174. eCollection 2018.
We describe here an unusual case of brain death following cardiac arrest. Brain electric activity had totally ceased, allowing the confirmation of brain death, despite normal cerebral blood flow (assessed by both transcranial doppler and tomodensitometry) and no evidence of intracranial hypertension. In our case, a residual electric activity was assessed at admission and lesions worsened on imaging during ICU stay, suggesting that part of the neuronal damage occurred after brain reperfusion. All these elements suggest BD rather by cellular toxicity than intracranial pressure elevation.
我们在此描述一例心脏骤停后出现脑死亡的罕见病例。尽管脑血流正常(经颅多普勒和断层扫描均评估)且无颅内高压证据,但脑电活动已完全停止,从而得以确认脑死亡。在我们的病例中,入院时评估存在残余电活动,且在重症监护病房住院期间影像学检查显示病变恶化,提示部分神经元损伤发生在脑再灌注之后。所有这些因素表明,脑死亡的原因更可能是细胞毒性而非颅内压升高。