Cardiac arrest can cause hypoxic–anoxic ischemic brain injury due to signaling cascades that lead to damaged cell membranes and vital cellular organelles, resulting in cell death in the setting of low or no oxygen. Some brain areas are more prone to damage than others, so patients with hypoxic–anoxic ischemic brain injury present with several outcomes, including reduced level of consciousness or alertness, memory deficits, uncoordinated movements, and seizures. Some patients may have mild deficits, while others may have such severe injury that it can progress to brain death. High-quality cardiopulmonary resuscitation is a proven technique to improve outcome after cardiac arrest, although morbidity and mortality remain high. Induced hypothermia, which involves artificially cooling the body immediately after cardiac arrest, may reduce injury to the brain and improve morbidity and mortality. Neuroprognostication after cardiac arrest is challenging and requires a multimodal approach involving clinical neurologic examinations, brain imaging, electrical studies to assess brain activity, and biomarkers to predict outcome.

中文翻译：

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心脏骤停后的危重大脑

心脏骤停可导致缺氧缺氧缺血性脑损伤，因为信号级联会导致细胞膜和重要的细胞器受损，从而在低氧或无氧环境下导致细胞死亡。一些大脑区域比其他区域更容易受到损伤，因此缺氧缺氧缺血性脑损伤患者会出现多种结果，包括意识或警觉性水平降低、记忆缺陷、运动不协调和癫痫发作。一些患者可能有轻微的缺陷，而另一些患者可能有严重的损伤，可能会发展为脑死亡。尽管发病率和死亡率仍然很高，但高质量的心肺复苏是一种经过验证的技术，可以改善心脏骤停后的预后。诱导低温，包括在心脏骤停后立即人工冷却身体，可以减少对大脑的伤害并提高发病率和死亡率。心脏骤停后的神经预后具有挑战性，需要采用多模式方法，包括临床神经系统检查、脑成像、评估大脑活动的电学研究和预测结果的生物标志物。