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Neurology: Magnetic resonance spectroscopy analysis of hypoxic-ischemic encephalopathy after cardiac arrest: decreased total NAA/CR and increased LAC/CR, increasing the risk of irreversible!

 Last Update: 2022-03-05
 Source: Internet
 Author: User

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Hypoxic-ischemic encephalopathy (HIE) brain injury is the leading cause of death and disability after cardiac arrest
.

In the United States, more than 377,000 adults suffer fatal cardiac arrest each year, and 80% of patients remain in a coma after cardiac arrest

Targeted temperature management (TTM) management in hypoxic-ischemic encephalopathy (HIE)

Although magnetic resonance spectroscopy (MRS) has been used to assess prognosis, few studies have examined the range of changes in brain-specific metabolic markers using TTM in adults
.

In neonatal patients with hypoxic-ischemic injury who received TTM, changes in the levels of n-acetyl-aspartate (NAA) and choline (cho) were associated with survival and neurodevelopmental outcomes after TTM

Magnetic resonance spectroscopy (MRS) changes in the levels of n-acetyl-aspartate (NAA) and choline (cho) and survival after TTM in neonatal patients with hypoxic-ischemic injury who received TTM associated with neurodevelopmental outcomes .

Recently, researchers detected metabolites in coma patients after cardiac arrest and assessed 1) the difference between patients with good/poor recovery from coma; Bring back (PCQ), parietal white matter (PWM), basal ganglia (BG) and brain stem (BS)

14 of the 50 recovered from a coma before being discharged from the hospital
.
The patient's overall n-acetyl-aspartate (NAA/CR) was significantly lower, and the lactate (LAC/CR) was significantly elevated without recovery.

The most obvious changes were in the posterior cingulate gyrus

Changes in NAA and lactate correlated with clinical/MRI/EEG changes consistent with hypoxic-ischemic encephalopathy (HIE) and were most pronounced in the posterior cingulate

Source: Lee JW, Sreepada L, Bevers M, et al.

Lee JW, Sreepada L, Bevers M, et al.
Magnetic Resonance Spectroscopy of Hypoxic-Ischemic Encephalopathy After Cardiac Arrest [published online ahead of print, 2022 Jan 11].
Neurology.
2022;10.
1212/WNL.
0000000000013297.
doi:10.
1212/WNL .
0000000000013297 leave a message here

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