Cardiopulmonary resuscitation
Diffuse hypoxic brain damage is rather common in patients with successful prehospital resuscitation by Emergency Medical System. The extent of revesible and irreversible neuropsychological lesions associated with hypoxia depends on age, preexisting diseases (e.g. cerebrovascular insufficiency) and duration of cardiorespiratory arrest . In those patients regaining consciousness despite persistent neu -ropsychological lesions the process of personality reorganization has little been studied. Personality reorganization was analysed in 20 patients with primarily deep coma after successful prehospital resuscitation (estimated mean duration of cardiac arrest 18 min.) followed by slow improvement of cerebral function and regaining "consciousness". Common features were reversible loss of short term memory and various kinds of acute exogenic reaction. Patients with possibly preexisting cerebral atrophy showed an apparently improved neuropsychological recovery. In 2 patients, personality reorganization showed striking similarities with earliest stages of childhood development. Careful analysis of personality reorganization may have most important implications for individualized rehabilitation strategies in patients after resuscitation.