Neurological syndromes after cardiac arrest.

CARDIOPULMONARY resuscitation has become commonplace activity, not just in emergency rooms and hospital intensive care units but even on the street. Largely because of the efforts of paramedical personnel in the community and the education of laymen in the techniques of cardiopulmonary resuscitation, there are more survivors from cardiac arrest than ever before. Neurological outcomes among survivors cover a broad spectrum, ranging from complete recovery to the vegetative state. Patients who awake promptly after resuscitation provide a gratifying experience to their physicians and present no problem in prognosis. However, neurologists are often asked to see patients in coma following cardiac arrest to help predict the degree of eventual recovery and to advise the family and plan future therapy. From our experience at San Francisco General Hospital we shall address two questions commonly posed by physicians caring for postcardiac arrest patients: What deficit and recovery profiles may be expected in patients after cardiac arrest? Can eventual neurological outcome be predicted for the individual patient?