It is widely recognized that anoxia produces acute neurological deficits, but many are unaware that severe neurological reactions may sometimes be delayed for days or weeks after anoxic exposure. Between the original anoxic coma and the relapse, intellectual and neurological recovery may seem complete, providing no hint that potentially fatal cerebral reactions have been initiated. The problem is not rare; 10 cases have been seen on this service in recent years. However, the syndrome has been discussed predominantly in the neurological literature and has attracted little attention in standard medical texts and periodicals.
This paper describes 5 patients to illustrate the clinical course of delayed neurological damage after anoxia. Pathological studies show the predominant nervous system abnormality in white matter rather than in neurones.
Materials and Methods
All patients except Patient 5 were seen. and examined by us. Most were patients in one of the University of Washington's Affiliated Hospitals.
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