Acute cardiac care & resuscitation

MRI-based quantitative profiling of hypoxic-ischemic brain injury in postanoxic status epilepticus and other EEG patterns

ResuscitationPublished Retrospective two-center observational study

Authors' conclusion

Postanoxic SE exhibited a more favorable HIBI profile than GPDs or malignant EEG patterns.

Study context

Population
Comatose patients after cardiac arrest, having EEG and brain MRI databenign 76 · generalized periodic discharges (GPDs) 46 · malignant 44 · SE 26
Participants
192 postanoxic patients
Exposure
We compared the extent of hypoxic-ischemic brain injury (HIBI) in postanoxic SE with other EEG patterns, particularly generalized periodic discharges (GPDs), using quantitative MRI analysis.
  • SEn = 26
  • GPDsn = 46
  • Malignantn = 44
  • Benignn = 76
Outcome
Neurological recovery
Follow-up
Discharge and 3 months
Methodological detailsconsecutive
  • Consecutive

Main finding

As reported in the abstract

Coma recovery at discharge 30.7%; CPC 1-2 at 3 months

21.2%

CPC 1-2 at 3 months

21.2%

Observational data: associations, not effects.

Further findings

OutcomeSEGPDsMalignantBenignP value
Whole-brain ADCSE vs malignant · significantly higher ADC in SE893 × 10-6 mm²/s838 × 10-6 mm²/smedian 750 × 10-6 mm²/s907 × 10-6 mm²/sP < 0.001
Whole-brain ADCSE vs GPDs · significantly higher ADC in SEP = 0.021
Whole-brain ADCSE vs benign · did not differP = 0.26
Whole-brain ADC — differed significantly across EEG patterns
p < 0.001

Regional and voxel-wise ADC

Confirmed these findings

Predictors of good outcome (multivariable models)

Higher occipital cortical ADC was an independent predictor of good outcome, alongside EEG pattern, clinical variables, and neuron-specific enolase

Original publication

MRI-based quantitative profiling of hypoxic-ischemic brain injury in postanoxic status epilepticus and other EEG patterns. Resuscitation. Published 25 May 2026. doi:10.1016/j.resuscitation.2026.111153

Summarised from the published abstract; every number is checked against it

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