Intact Neurological Recovery After Seven Days of Glasgow Coma Score 3T Following Near-Drowning and Hypothermia in an Adult

A 51-year-old male presented after accidental hypothermia with prolonged cardiac arrest and initiation of Cardiopulmonary Resuscitation (CPR) out of hospital. [...]the family had initiated palliative discussions when on day 8 the patient’s neurological status changed and dramatically improved over his remaining hospital course. [...]there are studies of drowning victims with severe anoxic encephalopathy on presentation recovering meaningful motor function as late as 48-72 h after resuscitation despite a grave initial neurological examination. 2 Based on anecdotal reports in literature and cardiac arrest data, it is suggested that poor outcome following drowning cannot be predicted reliably from an absence of pupillary reactivity or motor function until 24 h and 72 h (respectively) after resuscitation. 3 There have also been retrospective studies in children showing that in the cases of accidental drowning, even with prolonged resuscitation, hypothermia is positively associated with eventual neurologically intact recovery in survivors. 2 There are several individual case reports published detailing a slow but eventually intact neurological recovery after sequelae of prolonged resuscitation in adult hypothermic drowning victims.