Does Chronic Hypoxemia Cause Brain Injury?

The study of focal cerebral hypoxic ischemic injury (stroke) has yielded much information about sensorimotor and cognitive function. It has been more difficult to derive neuroanatomic or neurophysiologic insights from global cerebral hypoxic and/or ischemic injury, although the causes of either or both cerebral insults are protean and occur frequently. Recent studies have reported isolated behavioral deficits and particular patterns of cellular injury that follow any one of a number of causes of global hypoxic ischemic cerebral disease (the two forms of injury are often difficult to separate in clinical conditions), and include the following: sudden cardiopulmonary arrest,^1-5 sustained systemic hypotension,^6,7 cerebral ischemia that follows vasospasm,^8,9 and chronic hypoxemic pulmonary disease.¹⁰ In this issue of the Archives, Heaton et al (p 1941) have continued their study of patients with COPD. In an earlier publication, they analyzed the prevalence, quality, and severity of

See also p 1941.