Cerebral hypoxia

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Central nervous system

Hypoxic encephalopathy

Treatment depends on the underlying cause. Most importantly, basic life-support has to be ensured.

• Mechanical ventilation must be used
• Blood pressure must be supported with fluids, blood products, or medications
• Heart rate must be controlled
• Seizures, if they occur, must be treated

If seizures occur, medications including phenytoin, phenobarbital, valproic acid, and general anesthetics are used to suppress them (with variable degree of success).

Sometimes cooling with blankets (hypothermia) is used, because much of the brain damage in hypoxia is caused by heat. Those who suffer the condition (if it is caused by drowning, for instance) in cold temperatures generally survive longer than those who are affected in higher temperatures. However, the benefit of this treatment remains to be established.

Experimental drugs called neuroprotectants have not shown a significant benefit so far.

The outlook depends on the extent of the hypoxic brain injury, which is determined by how long the brain was deprived of oxygen. Most people who make a full recovery are unconscious only briefly.

The longer the patient is unconscious, the higher the chances of death or brain death, and the lower the chances of a meaningful recovery.

Complications of cerebral hypoxia include prolonged vegetative state -- basic life functions, such as breathing, blood pressure, sleep/wake cycle, and eye opening may be preserved, but there is no consciousness or response to the environment.

Prolonged vegetative state is usually followed by death in less than 1 year, although, rarely, it may last longer. Other complications depend upon the degree of neurologic function and include lung infections (pneumonia), improper nutrition, bed sores, and clots in the veins (deep vein thrombosis).

Cerebral hypoxia is a medical emergency, when every moment is critical for a chance of meaningful survival. Call 911 IMMEDIATELY if someone you are with is losing consciousness or has other symptoms consistent with cerebral hypoxia.

Review Date: 09/07/2006
Reviewed By: Kenneth Gross, M.D., Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.