Acute cardiac care & resuscitation
Histopathological patterns of hypoxic-ischemic encephalopathy after cardiac arrest: A retrospective brain autopsy study of 319 patients
Authors' conclusion
CA causes typical histopathological HIE patterns, with the hippocampus being more susceptible to SEND, than the cerebral neocortex, and the brainstem being the most resistant brain region. The neocortical distribution of SEND is mostly homogeneous; however, a relevant subgroup shows substantial neocortical HIE heterogeneity. Further studies are required to provide a more granular histopathological analysis of infrequent HIE patterns and their implications for neuroprognostication.
Study context
- Population
- Cardiac arrest (CA) patients with initially successful resuscitation, who had received brain autopsies after death
- Participants
- 319 patients
- Exposure
- Selective eosinophilic neuronal death (SEND) 0-1 versus SEND 2-4
- Outcome
- Mean SEND by brain region
Methodological detailsbrain autopsies
- Brain autopsies
Main finding
As reported in the abstract
Hippocampus
1.8
Neocortex
1.4
Brainstem
0.9
Observational data: associations, not effects.
Further findings
Typical histopathological hypoxic-ischemic encephalopathy (HIE) patterns
- (I) No or mild SEND in all brain regions
- (II) predominant SEND in hippocampus with no or mild SEND in other brain regions
- (III) severe SEND in neocortex, but not in brainstem
- (IV) severe SEND in the brainstem with neocortical HIE
SEND differing by more than 30% between two neocortical regions, of 72 patients with histopathology from two different neocortical regions
- Of 72 patients with two neocortical regions
- 7(9.7%)
Predominant SEND region among 154 patients with a SEND greater than 30% in at least one brain region
- Predominant SEND in cerebellum, of the 154
- 14(9.1%)
- Predominant SEND in basal ganglia, of the 154
- 4(2.6%)
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →