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重度创伤性脑损伤背景下“永久性”植物状态的延迟恢复:一项探索恢复与康复客观及主观方面的病例报告

Late-recovery from "permanent" vegetative state in the context of severe traumatic brain injury: A case report exploring objective and subjective aspects of recovery and rehabilitation.

作者信息

Illman Nathan Anthony, Crawford Sarah

机构信息

a The Royal Hospital for Neuro-disability , London , UK.

出版信息

Neuropsychol Rehabil. 2018 Dec;28(8):1360-1374. doi: 10.1080/09602011.2017.1313167. Epub 2017 Apr 26.

DOI:10.1080/09602011.2017.1313167
PMID:28446065
Abstract

This article provides a detailed outline of the recovery of a young male patient during his emergence from a vegetative state (VS) 19 months after suffering a severe traumatic brain injury. Several similar cases have been documented, but these tend not to consider the subjective experience of the patient or family; our aim was therefore to provide a detailed account that emphasises our neuropsychological exploration of the impact of the injury on this person, and looks at the experience of his mother along the timeline from his accident to the end of a successful period in rehabilitation. Clinical details are presented including standardised and non-standard assessments, neuropsychological interventions, as well as reflections from the patient himself. Moreover, qualitative data from an interview with his mother is used to illustrate the emotional impact on family of such a vacillating diagnostic status and prognosis for the future. We conclude that late-emergence from VS is increasingly documented and further cases must be published to better understand this phenomenon. The present case illustrates the emotional impact this situation can have on a patient and his or her family, and gives an important insight into a patient's view of his or her life and identity following such an event.

摘要

本文详细概述了一名年轻男性患者在重度创伤性脑损伤19个月后从植物人状态(VS)苏醒的过程。已有多例类似病例记录在案,但这些记录往往未考虑患者或其家人的主观体验;因此,我们的目的是提供一份详细的记述,着重阐述我们对该损伤对患者影响的神经心理学探索,并审视从其事故发生到康复成功阶段结束这段时间里他母亲的经历。文中呈现了临床细节,包括标准化和非标准化评估、神经心理学干预措施,以及患者本人的反思。此外,还利用了对其母亲的访谈所获得的定性数据,以说明这种摇摆不定且难以预测的诊断状况对家庭造成的情感影响。我们得出结论,越来越多的文献记录了VS的晚期苏醒情况,必须公布更多病例,以便更好地了解这一现象。本病例说明了这种情况对患者及其家人可能产生的情感影响,并为深入了解此类事件后患者对自己生活和身份的看法提供了重要视角。

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引用本文的文献

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Caring in the shadows: the pivotal role and unmet needs of caregivers for patients in a persistent vegetative state following traumatic brain injury.阴影中的关怀:创伤性脑损伤后处于持续性植物状态患者的照料者的关键作用及未被满足的需求
Patient Saf Surg. 2025 Aug 12;19(1):21. doi: 10.1186/s13037-025-00446-y.
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When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Neurobehavioral Progress.无反应觉醒综合征患者在何时、如何以及在何种程度上能够取得进展?神经行为进展。
Brain Sci. 2021 Jan 19;11(1):126. doi: 10.3390/brainsci11010126.
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When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence.
无反应觉醒综合征患者在何时、如何以及在何种程度上能够取得进展?功能独立性。
Brain Sci. 2020 Dec 16;10(12):990. doi: 10.3390/brainsci10120990.
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Point-of-care brain injury evaluation of conscious awareness: wide scale deployment of portable HCS EEG evaluation.意识清醒度的床旁脑损伤评估:便携式HCS脑电图评估的大规模应用
Neurosci Conscious. 2018 Nov 23;2018(1):niy011. doi: 10.1093/nc/niy011. eCollection 2018.