院外长时间心脏骤停后的显著恢复:缺氧缺血性脑病(HIE)与后可逆性脑病综合征(PRES)--病例报告。

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL AME Case Reports Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI:10.21037/acr-23-218
Nashat Singer, Muzan Abdelbagi, Abeer Alzuabi, Muaz Abdellatif Mohammed Elsayed
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引用次数: 0

摘要

背景:心脏骤停是最严重的脑血流损伤事件,会造成致命后果。有无旁观者进行心肺复苏、初始心律和心跳骤停时间等因素都会对结果产生重大影响。然而,尽管存在这些已知因素,人们对心脏骤停相关神经系统并发症的某些方面仍不甚了解。从有限的病例报告中可以看出,后可逆性脑病综合征(PRES)与心脏骤停之间的关联并不广为人知:我们介绍了一例院外心脏骤停(OHCA)病例研究,患者患有多种并发症,其神经系统结果可能会因此而复杂化。尽管患者在心脏骤停事件发生后恢复延迟,大脑也受到了初步损伤,但她的神经功能却得到了显著恢复。复杂的个体化针对性治疗促成了良好的结果:本病例研究就管理 OHCA 患者的复杂性、影响恢复的因素以及多学科团队对早期诊断和治疗 PRES 等疾病以防止永久性神经损伤的重要性提供了宝贵的见解。有必要在这一领域开展进一步的研究,以更好地了解此类关联的机制和影响,从而改善心脏骤停后的患者护理和预后。
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Remarkable recovery following prolonged out-of-hospital cardiac arrest: hypoxic-ischemic encephalopathy (HIE) versus posterior reversible encephalopathy syndrome (PRES)-a case report.

Background: Cardiac arrest is the most dramatic event that compromises the cerebral blood flow with fatal outcomes. Factors like the presence of bystander cardiopulmonary resuscitation, initial rhythm, and arrest time significantly influence outcomes. However, despite these known factors, there are still aspects of cardiac arrest-related neurological complications that remain less understood. As evidenced by limited case reports, the association between posterior reversible encephalopathy syndrome (PRES) and cardiac arrest is not widely known.

Case description: We present a case study of out-of-hospital cardiac arrest (OHCA) involving a patient with multiple comorbidities and factors that could complicate her neurological outcome. Despite experiencing a delayed recovery following the cardiac arrest event and an initial insult to the brain, the patient exhibited remarkable neurological recovery. There has been a complex individualized targeted management that contributed to the favorable outcome.

Conclusions: This case study provides valuable insights into the complexities of managing OHCA patients, the factors influencing recovery, and the importance of a multidisciplinary team for early diagnosis and treatment of conditions like PRES to prevent permanent neurological damage. Further research into this area is necessary to better understand the mechanisms and implications of such associations for improving patient care and outcomes following cardiac arrest.

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