A Major Miss in Prognostication after Cardiac Arrest: Burst Suppression and Brain Healing

We report a case with therapeutic hypothermia after cardiac arrest where meaningful recovery far exceeded all known outlying endpoints following cardiac arrest with loss of brainstem reflexes and subsequent status epilepticus. This man recovered after a cardiac arrest followed by a 6-week coma with absent motor response and 5weeks of burst suppression. Standard criteria suggested no chance of recovery. His recovery may relate to burst suppression to rescue neurons near neuronal cell death. Further research to understand the mechanisms of therapeutic hypothermia and late restoration of neuronal functional capacity may improve prediction and aid end-of-life decisions after cardiac arrest.
Source: Epilepsy and Behavior Case Reports - Category: Neurology Source Type: research