We report neuropsychological and neuropathological findings for a patient (A.B.), who developed memory impairment after a cardiac arrest at age 39. A.B. was a clinical psychologist who, although unable to return to work, was an active participant in our neuropsychological studies for 24 y. He exhibited a moderately severe and circumscribed impairment in the formation of long-term, declarative memory (anterograde amnesia), together with temporally graded retrograde amnesia covering ∼5 y prior to the cardiac arrest. More remote memory for both facts and autobiographical events was intact. His neuropathology was extensive and involved the medial temporal lobe, the diencephalon, cerebral cortex, basal ganglia, and cerebellum. In the hippocampal formation, there was substantial cell loss in the CA1 and CA3 fields, the hilus of the dentate gyrus (with sparing of granule cells), and the entorhinal cortex. There was also cell loss in the CA2 field, but some remnants remained. The amygdala demonstrated substantial neuronal loss, particularly in its deep nuclei. In the thalamus, there was damage and atrophy of the anterior nuclear complex, the mediodorsal nucleus, and the pulvinar. There was also loss of cells in the medial and lateral mammillary nuclei in the hypothalamus. We suggest that the neuropathology resulted from two separate factors: the initial cardiac arrest (and respiratory distress) and the recurrent seizures that followed, which led to additional damage characteristic of temporal lobe epilepsy.

我们报告了一名39岁心脏骤停后出现记忆障碍的患者（AB）的神经心理学和神经病理学发现。AB是一名临床心理学家，尽管无法重返工作岗位，但仍积极参与了我们24年来的神经心理学研究。 。在长期的声明性记忆（顺行性遗忘症）的形成中，他表现出中度严重且受限制的损害，以及在心脏骤停前约5 y的暂时性逆行性遗忘症。事实和自传事件都保留了更多的远程内存。他的神经病理学广泛，涉及颞中叶，间脑，大脑皮层，基底神经节和小脑。在海马结构中，CA1和CA3区域存在大量细胞损失，齿状回的hilus（保留颗粒细胞）和内嗅皮层。在CA2场中也有细胞丢失，但仍有一些残留物。杏仁核表现出明显的神经元损失，特别是在其深核中。在丘脑中，前核复合体，中嗅核和髓腔受到损害和萎缩。下丘脑的内侧和外侧乳核中也有细胞丢失。我们认为神经病理学是由两个独立的因素引起的：最初的心脏骤停（和呼吸窘迫）和随后的反复发作，这导致颞叶癫痫的其他损伤特征。杏仁核表现出明显的神经元损失，特别是在其深核中。在丘脑中，前核复合体，中嗅核和髓腔受到损害和萎缩。下丘脑的内侧和外侧乳核中也有细胞丢失。我们认为神经病理学是由两个独立的因素引起的：最初的心脏骤停（和呼吸窘迫）和随后的反复发作，这导致颞叶癫痫的其他损伤特征。杏仁核表现出明显的神经元损失，特别是在其深核中。在丘脑中，前核复合体，中嗅核和髓腔受到损害和萎缩。下丘脑的内侧和外侧乳核中也有细胞丢失。我们认为神经病理学是由两个独立的因素引起的：最初的心脏骤停（和呼吸窘迫）和随后的反复发作，这导致颞叶癫痫的其他损伤特征。