Hypoxic and Anoxic Brain Damage

Abstract

The ABRs of 16 infants and children, who had incurred brain damage as a sequela of hypoxic or anoxic incidents following near-suffocation or near-drowning, were obtained. There were eight patients assigned to the near-drowning (hypoxic) group and eight to the near-suffocation (anoxic) group. Clinically, all of these patients variably presented with cerebral palsy, mental retardation and/or epilepsy and had poor responses to VRA. Of the patients in the near-drowning group the ABR responses were abnormal in five of them, i.e., only waves I, II, and III were evoked in three of the cases and the amplitude of waves IV and V was low in two of the cases. Of the near-suffocation group ABRs were generally normal. This difference in the ABRs between the two groups suggests that, in infants and children, anoxic brain damage due to near-drowning might involve not only the cerebral cortex and subcortical white matter but also the upper brain stem and midbrain. To further study these different effects hypoxia and anoxia seen to have on the central nervous system, we recorded ABRs from the cat which were artificially respirated. Respiration was periodically arrested and then restored over various lengths of time. The ABRs were found to change within 7 min of respiratory arrest but they did not change after 3 min.