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January 1989

Acute Failure of Forebrain With Sparing of Brain-Stem Function: Electroencephalographic, Multimodality Evoked Potential, and Pathologic Findings

Author Affiliations

From the Division of Electroencephalography and Clinical Neurophysiology, Department of Laboratory Medicine (Drs Wytrzes and Chatrian and Ms Wirch), Neurological Surgery (Drs Chatrian and Shaw), and the Laboratory of Neuropathology, Department of Pathology (Dr Shaw), University of Washington School of Medicine, Seattle.

Arch Neurol. 1989;46(1):93-97. doi:10.1001/archneur.1989.00520370095028

• We describe a case of acute failure of forebrain with preservation of brainstem function following cardiopulmonary arrest. This condition is distinguished from persistent vegetative or noncognitive states. Multimodality evoked potentials showed electroretinograms but no cerebral potentials to flash stimulation of both eyes; normal electrocochleograms and brain-stem auditory-evoked potentials to click stimulation of both ears; and Erb's point, N1̄3̄, and P1̄4̄ but no cortical responses to electrical excitation of both median nerves. Pathologic alterations consisted of pseudolaminar necrosis involving the whole cerebral cortex and other forebrain regions, with relative preservation of brain stem and spinal cord. Close correspondence existed between electrophysiologic, clinical, and major neuropathologic alterations.