The goal of this case study is to find out more about irreversible coma. Further findings on coma will hopefully lead to a better treatment protocol. This study discovered that the body changes during cardiopulmonary arrest. Internal body pathology observation in detail and patient CT/MRI changes by the time the cardiopulmonary arrest happened.
During a cardiac arrest, the body slowly changes. Although an MRI reveals certain signs, it might take up to a day for a CT scan to detect the cardiac arrest. However, in 24 hours of monitoring, CT scans did not show any results. However, this time there was a cardiac arrest and internal bleeding. However, at CPR, the GWR (gray-white matter ratio) changes after cardiac arrest (Rana et al., 2021).
We found in the case study, the patient was healthy and fine. The hospital doctor and I have decided to come up with a case study from The Affiliated Hos-pital of Medical School of Ningbo University data and get other similar data from PubMed, Google scholar.
We have taken ECG, records from the ICU, a CT scan of the pulmonary artery, and a CT scan of the brain from the Ningbo University Hospital.
Case History
The procedure for spinal or epidural anaesthesia is very smooth. A 62-year-old man with an inguinal hernia who is otherwise healthy. The patient looked healthy, but during spinal anaesthesia, the patient had a cardiac arrest, and after CPR, the patient was in a coma.
The return of a patients normal neurological func-tion following effective cardiac resuscitation.
After one day, a CT scan reveals that the gray-white matter ratio (GWR) radiographic measure of tissue changes after cardiac arrest (Bone and Fuller, 2001), indicating hypoxic-ischemic encephalopathy. Due to hypoxic-ischemic encephalopathy, individuals resus- citated from cardiac arrest (CA) (Cronberg et al. 2020) has a high risk of death or survival in unres-ponsive wakefulness (HIE). After 24 hours, alter-ations in cerebral ischemia and an MRI scan are required. Changes in humans brains remain in a per-sistent vegetative state following resuscitation after cardiac arrest using high-field MR imaging (De Herdt, 2020).
MR images, but not CT scans, revealed what were assumed to be hemoglobin degradation products (Edlow et al. 2014). Which derived from minor haemorrhages localized in the thalami (Giacino et al., 2018), bilateral basal ganglia, and substantial. Several prognostic tests, such as EEG and neuro-logical examination, CT/MRI, have been found to have a high degree of specificity in predicting bad outcomes (Kondziella et al., 2020).
Alterations in cerebral ischemia; senile brain chan-ges; MRI scan if required; Mild inflammation of both lungs, with a little enlargement of the lower leaves of both lungs and a partial thickening of the pleura on both sides. After a CT scan has been per-formed for 24 hours (Nuwer, 2021), On both sides of the chest wall, there is a little degree of emphysema.
Fig. 1-6: CT SCAN OF BRAIN, After CPR CT scan results of DAY 1 TO DAY 4. Changes in cerebral ischemia; senile brain changes.
There was no obvious pleural effusion, and the two thoracic membranes had a localized uneven thic-kening. A little amount of gas density was found beneath both sides of the chest wall. The two lungs are obscured by a massive blur, with the lower left lungs boundary uncertain (Fig. 1 to 6). After 96 hours, a CT scan clearly demonstrates brain abnor-malities, GWR changes, and some gray matter with white portion plainly demonstrating the stroke (Young, 2009).
Multiple air shadows were detected under the chest walls on a CT scan of the pulmonary artery (Rabin-stein, 2018). Both sides of the pulmonary artery showed no evident indications of embolism. A minor quantity of fluid has accumulated in the chest, and the bottom portion of the lungs has partially expan-ded (Rossetti et al. 2016).
ECG Vector Examination + Routine ECG Examin-ation Check: R-wave in-crease of anterior wall of sinus rhythm unconscionable indoor conduction when combined with conventional ECG and ECG vector Part of the T-wave change Reporter is de-layed. The patients pupil and limb motions are more flexible than they were after 124 hours, but he is still not awake (Wijdicks, 2018). He had a tracheotomy this afternoon and the ICU data revealed partial hemorrhage (Traub and Wijdicks, 2016).
After cardiac arrest, measures of neurological state do not directly predict total functional prognosis (Trinka and Leitinger, 2015). GWR on brain CT and DW-MRI combined (Wijdicks, 2016), rather than each modality separately, appears to enhance sen-sitivity for predicting neurologic prognosis following cardiac arrest. To validate these findings, large pros-pective multicenter trials should be undertaken. The physique of the patient changes with time. It was proven by ICU data and an MRI/CT scan. The patient, on the other hand, shows no symptoms of being awake. After CPR, some people remain in a minimally aware or vegetative state, and only a small percentage of people awaken neurologically intact (Kumari et al., 2021; Pervin and Hassan, 2020).
Even yet, there is no way to bring the patient out of his coma. Despite this, the patients internal changes might be seen on an MRI or CT scan while he or she is in a coma. Body pathological changes are ap-parent.
No conflict of interest in conducting this research.
We thank the Affiliated Hospital of Medical School of Ningbo University and Professor Zhu Binbin for sharing and generating case data.
Academic Editor
Dr. Abduleziz Jemal Hamido, Deputy Managing Editor (Health Sciences), Universe Publishing Group (UniversePG), Haramaya, Ethiopia.
Institute of Nutrition and Food Science, University of Dhaka, Nilkhet Rd, Dhaka 1000, Bangladesh.
Hasibuzzaman MA, Hossain MA, Kumari K, Dey M, Hossen MM, and Zhu B. (2022). During COMA, body pathology of CT/MRI changes: a case report with literature review. Eur. J. Med. Health Sci., 4(2), 51-54. https://doi.org/10.34104/ejmhs.022.051054