Diagnostic pitfalls in patients with hypoxic brain damage: Three case reports

Vera Carina Zingler, Bernd Pohlmann-Eden

Résultat de recherche: Articleexamen par les pairs

8 Citations (Scopus)

Résumé

Objective: Our aim was to assess the possible diagnostic pitfalls in three patients with hypoxic brain damage who had partly conflicting clinical, biochemical, and electrophysiological data and were in a persistent vegetative state (PVS) following cardiac arrest (CA). Methods: Serum concentrations of the destruction proteins, neuron-specific enolase (NSE) and protein S-100B (S-100B), were measured on days 1-3, and 7; somatosensory evoked potentials (SEPs) were recorded within 48 h and on day 7 after CA. Results: Two patients had significantly increased concentrations of NSE and S-100B during the first 3 days after CA, a finding that indicates ongoing neuronal destruction. In contrast, the SEPs of these patients were normal or showed only a diminished amplitude configuration. In the third patient the SEPs demonstrated a bilateral loss of cortical responses repeatedly, but both destruction proteins were only slightly above the upper normal values on all study days. Conclusion: Our findings demonstrate that a poor prognosis can only be established if either SEPs, NSE, or S-100B are very abnormal. The conflicting results in our patients indicate that variable values may reflect different patterns of neuropathological damage caused by diffuse hypoxia. We, therefore, favour a multi-modal approach with a combination of clinical, biochemical, and electrophysiological investigations in order to predict neurological outcome after CA reliably.

Langue d'origineEnglish
Pages (de-à)107-110
Nombre de pages4
JournalResuscitation
Volume65
Numéro de publication1
DOI
Statut de publicationPublished - avr. 2005
Publié à l'externeOui

ASJC Scopus Subject Areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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Citer

Zingler, V. C., & Pohlmann-Eden, B. (2005). Diagnostic pitfalls in patients with hypoxic brain damage: Three case reports. Resuscitation, 65(1), 107-110. https://doi.org/10.1016/j.resuscitation.2004.11.008