We read with great interest the article “Early neurologic examination is not reliable for prognostication in post–cardiac arrest patients who undergo therapeutic hypothermia” [1]. Sudden cardiac arrest (SCA) outside the hospital due to heart disease is the most common cause of performing cardiopulmonary resuscitation (CPR). Survival after prehospital cardiac arrest primarily determines factors associated with the prehospital period during the course of resuscitation [2,3]. Studies on the pathomechanism of damage to the central nervous system as a result of cardiac arrest were mainly conducted on animals, and only a few clinical studies of hypoxia in neonates and hypoperfusion of the brain during cardiopulmonary bypass provided insights into underlying pathomechanisms in humans [4].