[Morphology of "resuscitation-induced encephalopathy"]

Two groups of changes in the cerebral substance were revealed by histological examinations of the central nervous system in a case of clinical death followed by respiratory resuscitation for 12 days. Changes of the 1st group consisted in foci of incomplete necrosis in the stage of organization in the cortex and dentate nuclei of the cerebellum, lower olives of the medulla, Zommer sector of the Ammon horn, and caudate nuclei. Their development is due to ischemia and circulatory hypoxia in the early resuscitation period. Changes of the 2nd group included acute disorders of microcirculation and extensive protein and carbohydrate dystrophy of nerve cells of the cortex and subcortical ganglia in the form of hyperchromatosis hydropic degeneration. "alzheimerization", accumulation of glycogen in the cytoplasm of neurons and astrocytes. The degenerative changes were combined with signs of gradual death of neurons and pseudolaminar losses in the cerebral cortex. Changes of the 2nd group may be classified as the so-called secondary nor delayed cerebral hypoxia in the development of which microcirculatory disorders are of importance. The observed morphological changes in the brain after clinical death and prolonged respiratory resuscitation represent morphological expression of "resuscitation-conditioned encephalopathy".