Hypoxic-ischemic encephalopathy induced cognitive decline secondary to upper gastrointestinal bleeding: a case report.

Hypoxic-ischemic encephalopathy (HIE) occurs more in neonatal and rarely in adults. In adults, HIE is commonly caused by carbon monoxide (CO) poisoning, shock, cardiac arrest, respiratory depression, anesthesia and drug overdose.[1-3] In patients with acute gastrointestinal bleeding, decreased circulating blood supply causes cerebral ischemia and hypoxia, leading to dizziness, syncope and even sudden death. However, these conditions are more common especially in elderly patients with cerebrovascular stenosis, acute massive blood loss, using hemostatic agents, and high-risk factors of cardiovascular and cerebrovascular disease.[4] Here, we reported a middle-aged male patient, who was diagnosed with HIE after upper gastrointestinal bleeding without these high-risk factors.