Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
Ther Hypothermia Temp Manag. 2023 Jun;13(2):87-89. doi: 10.1089/ther.2022.0064. Epub 2023 Feb 3.
Research on the causes of sudden cardiac arrest (CA) after ischemic stroke, especially disruption of the autonomic nervous system's central control, has recently focused more on the widespread cortical and subcortical network than on autonomic circuits at the spinal and brainstem level. However, no clinical case of sudden CA requiring cardiopulmonary resuscitation (CPR) after brainstem infarction has been reported. We report a case of a 78-year-old woman who died suddenly from a brainstem infarction. Her husband heard a falling sound and found her unresponsive and lying with agonal breathing. The initial cardiac rhythm was pulseless electrical activity confirmed by emergency medical technicians. Recovery of spontaneous circulation was achieved after CPR. Basilar artery occlusion was shown on computed tomography, but no other findings that could have caused CA were found. Targeted temperature management was initiated, but she died on hospital day 22. Brainstem infarction may cause sudden CA; therefore, definitive treatment may achieve better outcomes.
研究缺血性脑卒中后心搏骤停（CA）的原因，特别是自主神经系统中枢控制的中断，最近更多地集中在广泛的皮质和皮质下网络，而不是脊髓和脑干水平的自主回路。然而，尚未有报道称脑梗死患者发生需要心肺复苏（CPR）的脑干梗死后突发 CA 的临床病例。我们报告了一例 78 岁女性突发脑梗死死亡的病例。她的丈夫听到一声响声，发现她没有反应，并且处于濒死样呼吸。急救医务人员证实初始心搏节律为无脉性电活动。CPR 后恢复了自主循环。头部计算机断层扫描显示基底动脉闭塞，但未发现其他可能导致 CA 的异常。开始了目标温度管理，但她在住院第 22 天死亡。脑梗死可能导致心搏骤停；因此，明确的治疗可能会获得更好的结果。
