A multivariate assessment approach should be used to establish an early high-certainty prognosis after cardiac arrest. However, further prospective clinical studies are necessary to confirm this derived predictor index. In addition, an early recording of S-100B, long-latency sensory-evoked potential, and neuropsychological bedside screening reflect a cognitive long-term outcome.

This prospective study evaluated the prognostic value of early neurobiochemical markers, neuron-specific enolase and astroglial protein S-100B, for long-term cognitive outcome after cardiac arrest. Six months after admission of a cohort of 80 consecutive patients, 26 survivors were able to undergo a neuropsychological test battery. Survivors showed low test performances in attention, learning/memory, and executive functioning. Neuropsychological bedside screening during the first month significantly differentiated between patients with and without long-term cognitive impairment. The neurobiochemical marker S-100B at day 3 after admission was found to predict significant proportions of variance in specific cognitive domains (learning/memory and executive functioning). The results indicate that early neuropsychological assessment might help identify patients who run at risk of long-term neuropsychological dysfunction. This study also suggests that especially the protein S-100B provides valuable information on long-term cognitive outcomes. To understand the exact relationship, results have to be replicated in larger trials.

The purpose of this study was to examine the relationship between dissociative symptomatology and declarative and procedural memory. Subjects were 41 consecutively admitted adolescent psychiatric patients, 13 to 19 years old. Each subject completed the Adolescent Dissociative Experiences Scale (A-DES). Declarative memory was assessed by the California Verbal Learning Test and procedural memory by the Tower of Toronto puzzle. All subjects were controlled for IQ and severity of psychiatric illness. Data analysis was done by multiple regression. Multiple regression analysis revealed a model in which 71% variance of the A-DES scores was explained by psychiatric illness and specific memory variables. This study confirms a strong interrelationship between clinical dissociation and severity of psychiatric illness. Moreover, clinical dissociation seems to be associated with specific memory dysfunctions, indicating that dissociation exerts an impact on basic information processing.

Durch die Fortschritte in der Reanimations- und Intensivmedizin steigt die Anzahl von Patienten mit einer Hypoxisch-ischämischen Enzephalopathie (HIE). Das klinische Ausprägungsspektrum dieses Krankheitsbildes reicht von milden kognitiven Dysfunktionen bis hin zum Versterben des Patienten. Der Übersichtsartikel beleuchtet mögliche Entwicklungsverläufe dieser Patientenpopulation vom Akutstadium der Erkrankung bis in die postrehabilitative Phase unter besonderer Gewichtung der zu Grunde liegenden pathophysiologischen Mechanismen, der Prognosestellung sowie des neuropsychologischen und psychosozialen Outcomes. Dabei wird verdeutlicht, dass Verbesserungen in der akuten Rettungs- und Intensivmedizin gleichsam mit Verbesserungen des rehabilitativen und vor allem des postrehabilitativen Versorgungssystems einhergehen müssen – sowohl für Patienten als auch deren Angehörigen.