We studied the prognostic applicability of electroencephalograms (EEGs) of seventy-nine patients within 24 hours after successful cardiopulmonary resuscitation. The EEGswere classified into five grades according to a modified Hockaday's scale. The EEGs of grades I and II implied full recovery, while those of grade III gave a varied but generally unfavorable prognosis. Patients with grades IV and V EEGssurvived in a vegetative condition or died without awakening. Eighteen patients showed EEGwith periodic patterns, all of which led to a fatal or vegetative outcome. One case showed EEGs associated with periodic triphasic waves and repetitive sharp transients in the same record. Several cases showed EEGswith different periodic patterns in consecutive records.Weconclude that an EEGis a good indicator of patient prognosis after cardiopulmonary resuscitation. However, the clinical significance of morphological differences of various periodic patterns that can occur during an EEGremains to be established. (Internal Medicine 34: 71-76, 1995)

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The clinical significance of traumatic subarachnoid hemorrhage (TSAH) was studied in 20 head-in jured patients. They were classified into mild (9) and severe (11) groups by their initial Glasgow Coma Scale (GCS) scores. TSAH detected by computed tomography was localized in the Sylvian fissure in four of the nine mild group patients, but was also found in other basal subarachnoid cisterns in the other five. Except for one patient who developed delayed vasospasm and communicating hydro cephalus, all had favorable outcomes in this group. Massive TSAH was noted in the basal sub arachnoid cisterns in 10 severe group patients and only one had a good outcome. Delayed intra cerebral hematoma in the frontal or temporal lobe in the vicinity of the Sylvian fissure was found in two mild and two severe group patients with TSAH in the Sylvian fissures. Traumatic parenchymal lesions in the brainstem were minimal in one of the two autopsied patients and no evidence of diffuse axonal injury was found in both cases. Thus, TSAH in the Sylvian fissure is suggestive of focal brain contusion around the fissures. Massive TSAH in the basal subarachnoid cisterns is not necessarily asso ciated with severe parenchymal injury of the brainstem.

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Acute myocardial infarction (AMI) is one of the most intractable diseases and is increasing rapidly in Japan and China.