Which of the following is not a poor prognostic indicator after hypoxic brain injury?
A. Absence of pupillary or motor response to pain by the third day.
B. The loss of vestibuloocular responses at 12 hours and the presence of decerebrate or decorticate posturing at 24 hours.
C. Electroencephalogram (EEG) patterns: nonreactive EEG; burst suppression; alpha coma.
D. Absent cortical N20 on somatosensory evoked response at 72 hours, or unobtainable short-latency somatosensory evoked cortical potentials 8 hours after cardiorespiratory arrest.
E. Hypothermia at the time of the anoxic event.
F. The presence of either diffuse edema or watershed infarctions on CT scans.
G. Loss of gray-white matter distinction on CT scan and severe abnormalities on diffusion-weighted imaging.
Answer: E
Hypothermia at the time of the anoxic event may be protective; patients who have experienced near-drowning submerged in cold water up to 40 minutes may return to normal neurologic function.
N20 present at 8 hours has a 25% chance of recovery.
Reference
Irwin and Rippe’s Intensive Care Medicine 5th edition (January 2003): By Richard S., Md. Irwin (Editor), James M., Md. Rippe (Editor), Herbert P. Goodheart By Lippincott Williams & Wilkins Publishers