Partial recovery of vegetative state after a massive ischaemic stroke in a child with sickle cell anaemia.
clinical neurophysiology
neuroimaging
neurological injury
rehabilitation medicine
stroke
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
05 May 2020
05 May 2020
Historique:
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
20
1
2021
Statut:
epublish
Résumé
A 15-year-old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye opening and spastic quadriparesis with no evidence of command-following, gestural or verbal communication, visual pursuit or purposeful motor behaviour. Our case was in an 'unresponsive wakefulness syndrome' with atrophy of lateral and frontal regions of both hemispheres, demonstrated by MRI and preservation of circulation in the posterior arterial system, documented by MR angiography. Currently observed are spontaneous eye opening, preserved visual and auditory startle reflexes, normal brainstem reflexes, and grasp, palmomental and sucking reflexes. Our case demonstrates partial recovery of awareness with significant brain lesions, reflecting preserved brain activity as an indication of the modular nature of functional networks.
Identifiants
pubmed: 32376659
pii: 13/5/e233737
doi: 10.1136/bcr-2019-233737
pmc: PMC7228452
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMC Med. 2010 Nov 01;8:68
pubmed: 21040571
Neuropsychol Rev. 2001 Dec;11(4):179-96
pubmed: 11883668
Lancet. 1972 Apr 1;1(7753):734-7
pubmed: 4111204
NeuroRehabilitation. 2012;31(4):345-7
pubmed: 23232156
Neuroimage Clin. 2019;22:101702
pubmed: 30711681
Sci Adv. 2019 Feb 06;5(2):eaat7603
pubmed: 30775433
J Clin Invest. 2006 Jul;116(7):2005-11
pubmed: 16823492
Brain. 2002 Jun;125(Pt 6):1210-34
pubmed: 12023311
N Engl J Med. 1972 Oct 26;287(17):846-9
pubmed: 5071963
Curr Opin Neurol. 2006 Dec;19(6):520-7
pubmed: 17102688
Lancet Neurol. 2006 Jun;5(6):501-12
pubmed: 16713922
Curr Opin Hematol. 2007 May;14(3):191-7
pubmed: 17414206
Pediatr Radiol. 2005 Mar;35(3):249-57
pubmed: 15703900
Hemoglobin. 2011;35(5-6):618-24
pubmed: 21967673
J Child Neurol. 2000 May;15(5):333-43
pubmed: 10830200
Eur J Neurol. 2020 May;27(5):741-756
pubmed: 32090418
Hum Brain Mapp. 2017 Oct;38(10):4832-4833
pubmed: 28817216
Rev Neurosci. 2009;20(3-4):177-80
pubmed: 20157987
Blood. 2018 Oct 18;132(16):1714-1723
pubmed: 30061156