Case-Based Modules > Case 19 > Conclusion

Strong work. This was a sad result, but you knew that you had to proceed with identifying whether she had any of the strong predictors of a poor neurologic prognosis.

Pearl 1: The strongest predictors of a poor neurologic prognosis are 1) absent pupillary light reflexes at ≥ 72 hours from ROSC, and 2) absent N20 responses bilaterally on SSEPs at ≥ 48-72 hours from ROSC.

These strongest predictors have the most favorable false positive rates (not zero, of course), so we need to identify whether they hold for our patient first before moving on to the less reliable tests that have a greater degree of uncertainty. MRI, with its ability to identify diffusion restriction across cortex and deep gray matter, is only a moderate predictor.

Suggested Reading from this Case: