从最小反应状态的长期恢复：伴有损伤的上行网状激活系统恢复：一例报告。

Long-term recovery from a minimally responsive state with recovery of an injured ascending reticular activating system: A case report.

机构信息

Department of Physical Medicine and Rehabilitation.

Department of Neurosurgery, College of Medicine, Yeungnam University, Gyeongsan-si, Gyeongsangbuk-do.

出版信息

Medicine (Baltimore). 2021 Mar 5;100(9):e23933. doi: 10.1097/MD.0000000000023933.

DOI:10.1097/MD.0000000000023933

PMID:33655907

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7939211/

Abstract

We report on a patient with hypoxic-ischemic brain injury (HI-BI) who showed recovery from a minimally consciousness state over 6 years concurrent with recovery of an injured ascending reticular activating system (ARAS), which was demonstrated on diffusion tensor tractography (DTT).A 31-year-old female patient, who suffered from HI-BI, showed impaired consciousness with a minimally conscious state: intermittently obeying simple motor tasks, such as "please grasp my hand." Her consciousness showed recovery with the passage of time; rapid recovery was observed during the recent 2 years.In the upper ARAS, the neural connectivity to both the basal forebrain and prefrontal cortex had increased on 8-year DTT compared with 1.5-year DTT. In the lower dorsal and ventral ARAS, no significant change was observed between 1.5 and 8 years DTTs.Recovery of an injured ARAS was demonstrated in a patient who showed recovery from a minimally consciousness state over 6 years following HI-BI. Our results suggest the brain target areas for recovery of impaired awareness in patients with disorders of consciousness.

摘要

我们报告了一例缺氧缺血性脑损伤（HI-BI）患者，在弥散张量追踪（DTT）显示损伤的上行网状激活系统（ARAS）恢复的同时，该患者从最小意识状态中恢复，历时 6 年。一名 31 岁女性患者因 HI-BI 导致意识受损，表现为最小意识状态：间歇性服从简单的运动任务，如“请握住我的手”。随着时间的推移，她的意识逐渐恢复；在最近 2 年中，观察到快速恢复。在上行 ARAS 中，与 1.5 年 DTT 相比，8 年 DTT 时基底前脑和前额叶皮质的神经连接增加。在下部背侧和腹侧 ARAS 中，1.5 年和 8 年 DTT 之间未见明显变化。在 HI-BI 后 6 年，从最小意识状态中恢复的患者中，证明了损伤的 ARAS 恢复。我们的结果表明，在意识障碍患者中，受损意识恢复的大脑靶区。