Neuropathology of the vegetative state after head injury

Autor:	Lilian S. Murray, J H Adams, Bryan Jennett, David I. Graham
Rok vydání:	2005
Předmět:	Adult Male Adolescent Diffuse Axonal Injury Neuropathology Brain damage White matter Hematoma Arts and Humanities (miscellaneous) medicine Hematoma Subdural Acute Humans Glasgow Coma Scale Applied Psychology Aged Persistent Vegetative State Rehabilitation Head injury Diffuse axonal injury Brain Middle Aged medicine.disease Lucid interval Neuropsychology and Physiological Psychology medicine.anatomical_structure Brain Injuries Anesthesia Female medicine.symptom Psychology
Zdroj:	Neuropsychological Rehabilitation. 15:198-213
ISSN:	1464-0694 0960-2011
DOI:	10.1080/09602010443000452
Popis:	A detailed neuropathological study of patients identified clinically after head injury as either severely disabled (SD, n = 30) or vegetative (VS, n = 35) has been carried out to determine the nature and frequency of the various pathologies that form the basis of these clinical states. Patients who were SD were older (SD median 49.5 yrs vs. VS median 38 yrs, p = .04), more likely to have a lucid interval (SD 31% vs. VS 9%, p = .03), and to have had an acute intracranial haematoma (SD 70% vs. VS 26%, p < .001). SD patients less often had severe, Grades (2 or 3) of traumatic diffuse axonal injury (SD 30% vs. VS 71%, p = .001) and less often had thalamic damage (SD 37% vs. VS 80%, p < .001). Similar features of both focal and diffuse damage were present in some SD and VS cases with both groups having considerable damage to white matter and to the thalamus. It is concluded that the principal structural basis of both SD and VS is diffuse traumatic axonal injury (DAI) with widespread damage to white matter and changes in the thalami. However, both ischaemic brain damage and the vascular complications of raised intracranial pressure contributed to the clinical signs and symptoms.
Databáze:	OpenAIRE
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