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Hippocampal magnetic resonance imaging abnormalities in cardiac arrest are associated with poor outcome.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Greer, David M. Scripko, Patricia D. Wu, Ona Edlow, Brian L. Bartscher, James Sims, Jonathan R. Camargo, Erica E. C. Singhal, Aneesh B. Furie, Karen L.
Description	Author Affiliation: Greer DM ( Department of Neurology at Yale University School of Medicine, New Haven, Connecticut)
Abstract	BACKGROUND: The role of neuroimaging in assessing prognosis in comatose cardiac survivors appears promising, but little is known regarding the import of particular spatial patterns. We report a specific spatial imaging abnormality on magnetic resonance imaging (MRI) that portends a poor prognosis: bilateral hippocampal hyperintensities on diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences. METHODS: Eighty sequential comatose cardiac arrest patients underwent MRI scans. Qualitative and quantitative regional analyses were performed. Patients were categorized as HIPPO(+) (n = 18) or HIPPO(-) (n = 62) based on whether they had bilateral hippocampal hyperintensities. Poor outcome was defined by a modified Rankin Scale (mRS) score ≥4 at 6 months. RESULTS: Patients with bilateral hippocampal abnormalities had a higher frequency of poor outcome (P = .032). HIPPO(+) patients suffered more severe cerebral injury, with lower whole brain apparent diffusion coefficient values (P = .043) and a greater number of affected regions on DWI (P = .001) and FLAIR (P = .001) than HIPPO(-) patients. The hippocampal approach was 100% specific for a poor prognosis; only 1 patient survived and remained in a vegetative state. CONCLUSIONS: Bilateral hippocampal hyperintensities on MRI may be a specific imaging finding that is indicative of poor prognosis in patients who suffer global hypoxic-ischemic injury. More research on the prognostic significance of this and similar neuroimaging patterns is indicated.
File Format	HTM / HTML
ISSN	10523057
Issue Number	7
Volume Number	22
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Coma Prognosis Complications Mortality Humans Middle Aged Male Heart Arrest Journal Article Pathology Magnetic Resonance Imaging Discipline Cardiology Female Aged Hippocampus
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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