Management of brain injury after cardiac arrest

Cardiac arrest survivors are commonly admitted to an intensive care unit. Neurologic complications of cardiac arrest lead to significant morbidity in survivors. Advances in resuscitative efforts have led to an increase in the number of people who survive cardiac arrest, with a resultant increase in survivors suffering from postanoxic encephalopathy. The focus of resuscitation has shifted to emphasize interventions that restore adequate systemic circulation and those that will ameliorate brain injury after cardiac arrest resuscitation. Recent data about therapeutic hypothermia and other interventions have led to a shift in the role of the neurologist caring for these patients to promote more aggressive management of neurologic complications, including coma, encephalopathy, seizures and myoclonus, elevated intracranial pressure, and metabolic derangements. This chapter will review the neurologic complications of cardiac arrest and focus on the role of the neurologist in the management of such complications.