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Chapter 9

Neurologic Complications of Cardiac Arrest

CAROLYN M. BENSON and G. BRYAN YOUNG

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Figure 9-1 Normal somatosensory evoked potential elicited by stimulation of the right median nerve at the wrist. Responses were recorded over the brachial plexus at ipsilateral Erb point (EPi), over the fifth cervical spine (CV5), and over the ipsilateral scalp (C4′) with contralateral Erb point (EPc) used as a reference, as well as over the contralateral scalp (C3′) referenced to the ipsilateral scalp (C4′). An N9 potential is seen over Erb point, an N13 over the cervical spine, subcortical far-field P14 and N18 potentials over the ipsilateral scalp area, and an N20 over the contralateral “hand” area (C3′) of the scalp. Loss of the N20 response bilaterally (with preserved N9 and N13 responses) portends a poor neurologic prognosis.(From Aminoff MJ, Eisen A: Somatosensory evoked potentials. p. 581. In Aminoff MJ (ed): Aminoff’s Electrodiagnosis in Clinical Neurology. 6th Ed. Elsevier, Oxford, 2012, with permission.)

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Figure 9-2 Burst-suppression pattern recorded in the EEG of a 70-year-old man after a cardiac arrest from which he was resuscitated.(From Aminoff MJ: Electroencephalography: General principles and clinical applications. p. 37. In Aminoff MJ (ed): Aminoff’s Electrodiagnosis in Clinical Neurology. 6th Ed. Elsevier, Oxford, 2012, with permission.)

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Figure 9-3 Axial brain MRI after cardiac arrest, demonstrating extensive restricted diffusion consistent with cytotoxic edema.