Critical neural targets for (the level of) human consciousness: Arousal arrest and unconsciousness after sumatriptan administration
| Autor: | Antti Brander, Kai Lehtimäki, Lauri Herrala, Kari Saarinen, Jyrki Ruohonen, Satu Sandell, Anne Sajanti, Hannu T. Heikkilä, Jaakko Långsjö |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Adolescent media_common.quotation_subject Migraine Disorders Thalamus Neuroscience (miscellaneous) Unconsciousness ta3112 Arousal 03 medical and health sciences 0302 clinical medicine Level of consciousness 030202 anesthesiology Developmental and Educational Psychology medicine Image Processing Computer-Assisted Humans Vasoconstrictor Agents media_common Sumatriptan Magnetic Resonance Imaging Diffusion Tensor Imaging Anesthesia Wakefulness Neurology (clinical) Brainstem medicine.symptom Consciousness Psychology Neuroscience 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Brain injury. 30(13-14) |
| ISSN: | 1362-301X |
| Popis: | Insufficient understanding of the mechanisms of consciousness can make unconsciousness a diagnostic challenge, directly effecting the treatment and the outcome of the patient. Consciousness is a product of brainstem arousal (wakefulness, the level of consciousness) and cortical information integration (awareness, the contents of consciousness). The thalamus serves as a critical hub in the arousal pathway. The nuclei within the internal medullary lamina, together with the associated thalamocortical connections, have been implicated as being especially important for human consciousness.A 17-year old male migraineur developed a sudden episode of unconsciousness after receiving a single dose of intranasal sumatriptan for the treatment of prolonged migraine-associated symptoms. Diffusion-weighted magnetic resonance imaging revealed a small bilateral thalamic infarction affecting the centromedian and parafascicular nuclei and the associated non-specific thalamocortical connections as the likely reason for the impairment of consciousness. With the exception of occasional fatigue due to a persistent lesion on the left thalamus, the patient experienced full recovery. Corresponding to the injury, diffusion tensor tractography imaging revealed a distinctive defect on the thalamocortical fibres originating from the left centromedian/parafascicular nuclei complex.The presented case offers an outstanding example of the importance of the arousal system and non-specific thalamocortical connectivity for normal waking consciousness. |
| Databáze: | OpenAIRE |
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