Neuropsychological and neuropathological sequelae of cerebral anoxia: A critical review

Fifty-eight studies of the neuropathological and neuropsychological outcome s of cerebral anoxia were reviewed. Neuropathological reports were examined for the variety, extent, and specificity of lesions resulting from an anox ic event. While most attention has focused on damage to the hippocampus fol lowing anoxic brain injury,the review indicated that watershed cerebral cor tex and the basal ganglia were both more frequently damaged than the hippoc ampus. The hippocampus was the sole affected structure in only 18% of repor ted cases. Neurological, neuropsychological and psychiatric studies were an alyzed. Of 67 individual case reports, a memory disturbance was documented in 36 (54%), but a memory disturbance without report of additional cognitiv e deficits occurred in only 13 (19.4%). Changes in personality and behavior were noted in 31 (46.2%). Visuospatial or, less frequently, visual recogni tion problems were noted in 21 individual eases (31.3%) reviewed. Memory de ficits were found in all 14 group studies reviewed, while in 9 papers chang es in behavior or personality were also documented. Six studies also report ed visuospatial deficits. Careful reading of the literature reveals a range of cognitive and behavioral changes that reflect very well the neuropathol ogical outcomes of anoxic episodes.