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MR Imaging in Comatose Survivors of Cardiac Resuscitation

MR Imaging in Comatose Survivors of Cardiac Resuscitation This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wijdicks, E. F. M. Articles by Miller, G. M. Search for Related Content PubMed PubMed Citation Articles by Wijdicks, E. F. M. Articles by Miller, G. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 22:1561-1565 (9 2001) © 2001 American Society of Neuroradiology ARTICLE MR Imaging in Comatose Survivors of Cardiac Resuscitation Eelco F. M. Wijdicks a , Norbert G. Campeau a and Gary M. Miller a a From the Departments of Neurology (E.F.M.W.) and Diagnostic Radiology (N.G.C., G.M.M.), Mayo Medical Center and Mayo Foundation, Rochester, Minnesota. BACKGROUND AND PURPOSE: The prognosis of comatose survivors is determined by clinical examination. Early laboratory indicators of poor prognosis (such as evoked potentials) have low sensitivity. The role of MR imaging as a confirmatory study was investigated. METHODS: We studied fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted (DW) imaging in 10 patients comatose after cardiac arrest. RESULTS: None of the 10 comatose patients had myoclonus status epilepticus or fixed, dilated pupils on neurologic examination, and none had abnormal somatosensory-evoked potentials. Eight patients showed diffuse signal abnormalities, predominantly in the cerebellum (n = 5), the thalamus (n = 8), the frontal and parietal cortices (n = 8), and the hippocampus (n = 9). One patient showed normal MR imaging results, and one patient had abnormalities in the thalamus and cerebellum and minimal abnormality on DW images; both later awakened. None of the patients with abnormal cortical structures on FLAIR MR images recovered beyond a severely disabled state. CONCLUSION: MR imaging in comatose survivors may parallel the pathologic findings in severe anoxic-ischemic injury, and extensive abnormalities may indicate little to no prospects for recovery. If confirmed, MR imaging may have a role as a prognosticating test in anoxic-ischemic coma. This article has been cited by other articles: V. F. J. Newcombe, G. B. Williams, D. Scoffings, J. Cross, T. A. Carpenter, J. D. Pickard, and D. K. Menon Aetiological differences in neuroanatomy of the vegetative state: insights from diffusion tensor imaging and functional implications J. Neurol. Neurosurg. Psychiatry, May 1, 2010; 81(5): 552 - 561. Abstract Full Text PDF G. B. Young Neurologic Prognosis after Cardiac Arrest N. Engl. J. Med., August 6, 2009; 361(6): 605 - 611. Full Text PDF O. Wu, A. G. Sorensen, T. Benner, A. B. Singhal, K. L. Furie, and D. M. Greer Comatose Patients with Cardiac Arrest: Predicting Clinical Outcome with Diffusion-weighted MR Imaging1 Radiology, July 1, 2009; 252(1): 173 - 181. Abstract Full Text PDF R. W. Neumar, J. P. Nolan, C. Adrie, M. Aibiki, R. A. Berg, B. W. Bottiger, C. Callaway, R. S.B. Clark, R. G. Geocadin, E. C. Jauch, et al. Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council Circulation, December 2, 2008; 118(23): 2452 - 2483. Full Text PDF J.M. Pollock, C.T. Whitlow, A.R. Deibler, H. Tan, J.H. Burdette, R.A. Kraft, and J.A. Maldjian Anoxic Injury-Associated Cerebral Hyperperfusion Identified with Arterial Spin-Labeled MR Imaging AJNR Am. J. Neuroradiol., August 1, 2008; 29(7): 1302 - 1307. Abstract Full Text PDF B. Y. Huang and M. Castillo Hypoxic-Ischemic Brain Injury: Imaging Findings from Birth to Adulthood RadioGraphics, March 1, 2008; 28(2): 417 - 439. Abstract Full Text PDF K. M. Barrett, W. D. Freeman, S. M. Weindling, T. G. Brott, D. F. Broderick, M. G. Heckman, J. E. Crook, G. D. Divertie, and J. F. Meschia Brain Injury After Cardiopulmonary Arrest and Its Assessment With Diffusion-Weighted Magnetic Resonance Imaging Mayo Clin. Proc., July 1, 2007; 82(7): 828 - 835. Abstract Full Text PDF E.F.M. Wijdicks, A. Hijdra, G. B. Young, C. L. Bassetti, and S. Wiebe Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, July 25, 2006; 67(2): 203 - 210. Abstract Full Text PDF A. M. McKinney, M. Teksam, R. Felice, S. O. Casey, R. Cranford, C. L. Truwit, and S. Kieffer Diffusion-Weighted Imaging in the Setting of Diffuse Cortical Laminar Necrosis and Hypoxic-Ischemic Encephalopathy AJNR Am. J. Neuroradiol., November 1, 2004; 25(10): 1659 - 1665. Abstract Full Text PDF P. F. Finelli and F. J. DiMario Jr. Hemorrhagic infarction in white matter following acute carbon monoxide poisoning Neurology, September 28, 2004; 63(6): 1102 - 1104. Abstract Full Text PDF P F Finelli and D F Uphoff Magnetic resonance imaging abnormalities with septic encephalopathy J. Neurol. Neurosurg. Psychiatry, August 1, 2004; 75(8): 1189 - 1191. Abstract Full Text PDF T. Hirai, K. Suginohara, S. Uemura, J.-i. Hamada, Y. Korogi, and M. Takahashi Management of aneurysm perforation during Guglielmi electrodetachable coil placement. AJNR Am. J. Neuroradiol., April 1, 2002; 23(4): 738 - 739. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

MR Imaging in Comatose Survivors of Cardiac Resuscitation

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Publisher
American Journal of Neuroradiology
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Copyright © 2010 by the American Society of Neuroradiology.
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0195-6108
eISSN
1936-959X
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Abstract

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wijdicks, E. F. M. Articles by Miller, G. M. Search for Related Content PubMed PubMed Citation Articles by Wijdicks, E. F. M. Articles by Miller, G. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 22:1561-1565 (9 2001) © 2001 American Society of Neuroradiology ARTICLE MR Imaging in Comatose Survivors of Cardiac Resuscitation Eelco F. M. Wijdicks a , Norbert G. Campeau a and Gary M. Miller a a From the Departments of Neurology (E.F.M.W.) and Diagnostic Radiology (N.G.C., G.M.M.), Mayo Medical Center and Mayo Foundation, Rochester, Minnesota. BACKGROUND AND PURPOSE: The prognosis of comatose survivors is determined by clinical examination. Early laboratory indicators of poor prognosis (such as evoked potentials) have low sensitivity. The role of MR imaging as a confirmatory study was investigated. METHODS: We studied fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted (DW) imaging in 10 patients comatose after cardiac arrest. RESULTS: None of the 10 comatose patients had myoclonus status epilepticus or fixed, dilated pupils on neurologic examination, and none had abnormal somatosensory-evoked potentials. Eight patients showed diffuse signal abnormalities, predominantly in the cerebellum (n = 5), the thalamus (n = 8), the frontal and parietal cortices (n = 8), and the hippocampus (n = 9). One patient showed normal MR imaging results, and one patient had abnormalities in the thalamus and cerebellum and minimal abnormality on DW images; both later awakened. None of the patients with abnormal cortical structures on FLAIR MR images recovered beyond a severely disabled state. CONCLUSION: MR imaging in comatose survivors may parallel the pathologic findings in severe anoxic-ischemic injury, and extensive abnormalities may indicate little to no prospects for recovery. If confirmed, MR imaging may have a role as a prognosticating test in anoxic-ischemic coma. This article has been cited by other articles: V. F. J. Newcombe, G. B. Williams, D. Scoffings, J. Cross, T. A. Carpenter, J. D. Pickard, and D. K. Menon Aetiological differences in neuroanatomy of the vegetative state: insights from diffusion tensor imaging and functional implications J. Neurol. Neurosurg. Psychiatry, May 1, 2010; 81(5): 552 - 561. Abstract Full Text PDF G. B. Young Neurologic Prognosis after Cardiac Arrest N. Engl. J. Med., August 6, 2009; 361(6): 605 - 611. Full Text PDF O. Wu, A. G. Sorensen, T. Benner, A. B. Singhal, K. L. Furie, and D. M. Greer Comatose Patients with Cardiac Arrest: Predicting Clinical Outcome with Diffusion-weighted MR Imaging1 Radiology, July 1, 2009; 252(1): 173 - 181. Abstract Full Text PDF R. W. Neumar, J. P. Nolan, C. Adrie, M. Aibiki, R. A. Berg, B. W. Bottiger, C. Callaway, R. S.B. Clark, R. G. Geocadin, E. C. Jauch, et al. Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council Circulation, December 2, 2008; 118(23): 2452 - 2483. Full Text PDF J.M. Pollock, C.T. Whitlow, A.R. Deibler, H. Tan, J.H. Burdette, R.A. Kraft, and J.A. Maldjian Anoxic Injury-Associated Cerebral Hyperperfusion Identified with Arterial Spin-Labeled MR Imaging AJNR Am. J. Neuroradiol., August 1, 2008; 29(7): 1302 - 1307. Abstract Full Text PDF B. Y. Huang and M. Castillo Hypoxic-Ischemic Brain Injury: Imaging Findings from Birth to Adulthood RadioGraphics, March 1, 2008; 28(2): 417 - 439. Abstract Full Text PDF K. M. Barrett, W. D. Freeman, S. M. Weindling, T. G. Brott, D. F. Broderick, M. G. Heckman, J. E. Crook, G. D. Divertie, and J. F. Meschia Brain Injury After Cardiopulmonary Arrest and Its Assessment With Diffusion-Weighted Magnetic Resonance Imaging Mayo Clin. Proc., July 1, 2007; 82(7): 828 - 835. Abstract Full Text PDF E.F.M. Wijdicks, A. Hijdra, G. B. Young, C. L. Bassetti, and S. Wiebe Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, July 25, 2006; 67(2): 203 - 210. Abstract Full Text PDF A. M. McKinney, M. Teksam, R. Felice, S. O. Casey, R. Cranford, C. L. Truwit, and S. Kieffer Diffusion-Weighted Imaging in the Setting of Diffuse Cortical Laminar Necrosis and Hypoxic-Ischemic Encephalopathy AJNR Am. J. Neuroradiol., November 1, 2004; 25(10): 1659 - 1665. Abstract Full Text PDF P. F. Finelli and F. J. DiMario Jr. Hemorrhagic infarction in white matter following acute carbon monoxide poisoning Neurology, September 28, 2004; 63(6): 1102 - 1104. Abstract Full Text PDF P F Finelli and D F Uphoff Magnetic resonance imaging abnormalities with septic encephalopathy J. Neurol. Neurosurg. Psychiatry, August 1, 2004; 75(8): 1189 - 1191. Abstract Full Text PDF T. Hirai, K. Suginohara, S. Uemura, J.-i. Hamada, Y. Korogi, and M. Takahashi Management of aneurysm perforation during Guglielmi electrodetachable coil placement. AJNR Am. J. Neuroradiol., April 1, 2002; 23(4): 738 - 739. Full Text PDF Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of Neuroradiology – American Journal of Neuroradiology

Published: Sep 1, 2001

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