Table of Contents

Cerebral hypoxia

see Ischemic Stroke

Form of hypoxia (reduced supply of oxygen) specifically involving the brain

Diagnosis

Magnetic resonance spectroscopy (MRS): lactate.

Treatment

Check ABG, respiratory rate.

Intubate any patient who has hypercarbia, hypoxemia, or is not localizing

Complications

The occipital poles are particularly vulnerable to diffuse hypoxia 1); attested to by cases of cortical blindness after cardiac arrest 2). Hypotension superimposed on compromised PCA circulation (from herniation or elevated ICP) may thus increase the risk of postgeniculate blindness. 3), 4).

Risk of seizures.

Vascular pain syndrome

1)
Hoyt WF, Walsh FB. Cortical Blindness with Partial Recovery Following Cerebral Anoxia from Cardiac Arrest. Arch Ophthalm. 1958; 60:1061–1069
2)
Weinberger HA, van der Woude R, Maier HC. Prognosis of Cortical Blindness Following Cardiac Arrest in Children. JAMA. 1962; 179:126–129
3)
Arroyo HA, Jan JE, McCormick AQ, et al. Permanent Visual Loss After Shunt Malfunction. Neurology. 1985; 35:25–29
4)
Lindenberg R, Walsh FB. Vascular Compressions Involving Intracranial Visual Pathways. Tr Am Acad Ophth Otol. 1964; 68:677–694