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首页> 外文期刊>Brain injury: BI >Neuropathology of prolonged unresponsive wakefulness syndrome after blunt head injury: Review of 100 post-mortem cases
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Neuropathology of prolonged unresponsive wakefulness syndrome after blunt head injury: Review of 100 post-mortem cases

机译：钝头损伤后长期无响应综合征的神经病理学：审查100次验尸病例

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Objectives: Recently, 'unresponsive wakefulness syndrome' (UWS) was coined for challenging conditions previously termed vegetative state or apallic syndrome. Materials and methods: In a post-mortem series of 630 patients who sustained a blunt traumatic brain injury, 100 (59 men and 41 women, aged 5-86 years; 77% traffic accidents, 23% falls and others) showed various disorders of consciousness which were compared with neuropathology with focus on brainstem lesions. Results: In the total autopsy series (n=630), the incidence of cortical contusions, diffuse axonal injury (DAI) and intracranial haemorrhages was 41, 55 and 73%, respectively, of diencephalic, hypothalamic and hippocampal lesions 62% each, brainstem lesions 92%. Clinical prognosis was related to the location and extent of brainstem damage. Lesions in central parts of the rostral brainstem, frequently associated with extensive DAI, allowed no recovery from coma or UWS (n=67), which occurred only with damage to the dorso-lateral brainstem tegmentum or pontine basis (n=33). Only two of 11 patients with minimally conscious state (MCS), in addition to haemorrhages (n=4), contusions (n=10) and DAI (n=7), showed small lesions in dorsolateral pontine tegmentum or diffuse pontine gliosis. Conclusions: These and other data confirm the importance of the pattern and extent of brainstem damage for the prognosis of UWS, only small peripheral lesions in pontine tegmentum allowing progressive remission.
机译：目的：最近，“无响应醒来综合征”（UWS）被挑选以挑战以前称为营养态或野性综合征。材料和方法：在630名患者的后验尸系列中，患有钝的创伤性脑损伤，100名（59名男性和41名女性，年龄5-86岁;交通事故77％，23％跌落等）显示了各种障碍与神经病理学相比的意识，重点是脑干病变。结果：在总尸检系列（n = 630）中，皮质缺血的发生率，弥漫性轴突损伤（DAI）和颅内出血分别为41,55和73％，每次，脑干病变92％。临床预后与脑干损伤的位置和程度有关。讲话脑干的中央部分的病变经常与广泛的DAI相关，允许从昏迷或UWS（n = 67）中恢复，这仅因损伤背侧脑干tegmentum或粪便的基础而发生（n = 33）。除了出血（n = 4）之外，只有两个患者中只有11名患者，常规（n = 10）和dai（n = 7），表现出小病毒鼠栓塞或弥漫性猪脊髓症的小病变。结论：这些和其他数据确认了UWS预后脑干损伤模式和程度的重要性，只有小的外周病变，粪便Tegmentum允许进行渐进式缓解。

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