Emergence from protracted unconsciousness due to severe diffuse axonal brain injury: clinical observation and literature review
https://doi.org/10.14412/2074-2711-2013-2414
Abstract
The paper gives data available in the literature on the variants of unconsciousness, bases of their development, and modes of correction. The authors analyze their observation of consciousness recovery after protracted unconsciousness (for about 6 months) during neuromodulation therapy and repetitive transcranial magnetic stimulation (rTMS) in a patient with severe traumatic and, probably, concominant hypoxic brain injury. Over time (within 2 years), they traced neurological and psychic changes, evaluated structural damages by Tl-, T2-weighted, FLAIR, and DTI magnetic resonance imaging, by constructing corticospinal tracts, and cerebral blood flow (computed tomography perfusion), and plasma catecholamines (epinephrine, norepinephrine, and dopamine). The case in question is clinical, instrumental, and laboratory evidence for the efficiency of use of not only direct stimulants of dopaminergic transmission, but also drugs with indirect dopaminergic activity, as well as rTMS for emergence from protracted akinetic mutism in the presence of akinetic-rigid syndrome.
About the Authors
Evgenia Vladimirovna AleksandrovaO S Zaitsev
M V Chelyapina
E V Sharova
E Yu Sokolova
V M Gavrilov
N E Zakharova
Yu V Vorobyev
V D Tenediyeva
V A Shurkhai
E M Troshina
A A Potapov
References
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Review
For citations:
Aleksandrova E.V., Zaitsev O.S., Chelyapina M.V., Sharova E.V., Sokolova E.Yu., Gavrilov V.M., Zakharova N.E., Vorobyev Yu.V., Tenediyeva V.D., Shurkhai V.A., Troshina E.M., Potapov A.A. Emergence from protracted unconsciousness due to severe diffuse axonal brain injury: clinical observation and literature review. Neurology, Neuropsychiatry, Psychosomatics. 2013;5(2):51-58. (In Russ.) https://doi.org/10.14412/2074-2711-2013-2414
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