NCCEd: Neurocritical Care Education for Residents

Case-Based Modules > Case 20 > Stage 2

Very close. This would normally be the correct answer at this stage, as absent N20s on SSEPs bilaterally at ≥ 48-72 hours from ROSC are a strong predictor of a poor neurologic prognosis. Unfortunately, this patient has an acute cervical cord injury. We cannot rely on SSEPs as a result, as the electrical signal from stimulation may not reach the cortex, reflecting this pathway connection issue rather than a problem with the cortical response itself.

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Suggested Reading:

• Rajajee V, Muehlschlegel S, Wartenberg KE, et al. Guidelines for Neuroprognostication in Comatose Adult Survivors of Cardiac Arrest. Neurocritical Care. 2023;doi:10.1007/s12028-023-01688-3