No abstract available.
Humans ; Persistent Vegetative State*

No abstract available.
Brain ; Brain Death ; Persistent Vegetative State ; Regeneration

Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. This indicated the patient showed signs of learning. This state was confirmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and offer new opportunities for education to MCS patients.
Aged ; Coma ; Female ; Humans ; Learning ; Persistent Vegetative State

Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. This indicated the patient showed signs of learning. This state was confirmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and offer new opportunities for education to MCS patients.
Aged ; Coma ; Female ; Humans ; Learning ; Persistent Vegetative State

Although the life expectancy of posttraumatic persistent vegetative state is obviously expected to be shorter than that of the general population, exact estimates of the length of survival are not available, however. The author, after reviewing literatures on the definition, criteria for diagnosis, and prognosis of the persistent vegetative state, has proposed a table for the estimation of life expectancy of posttraumatic persistent vegetative state. In this proposal, age and sex of the patient as well as the duration of the vegetative state were used as determining factors of lifespan. Although this proposal is not based on the actual data, it still could serve as a helpful reference to estimate the patients life expectancy and minimizing discrepancies among clinicians with different personal experience.
Craniocerebral Trauma ; Diagnosis ; Humans ; Life Expectancy* ; Persistent Vegetative State* ; Prognosis

No abstract available.
Adult ; Dumping Syndrome ; Gastrostomy ; Humans ; Persistent Vegetative State

Severe hemorrhage of the basal ganglia is usually associated with massive surrounding edema, and even after removal of the hematoma, edema persists for as long as several weeks and exerts an additional deleterious effect on the recovery from the ictus. To determine whether the provision of intracranial space will improve the outcome, we performed temporal lobectomy in addition to hematoma removal and compared the result with hematoma removal only. Over a three-year period from January 1993 to March 1996, we encountered 476 cases of spontaneous intracerebral hemorrhage and of these, 52 with severe hemorrhage of the basal ganglia were selected for this study. On admission, the neurological status of these 52 patients was very poor or progressively deteriorating, and all underwent surgical intervention. They were divided into two groups according to the surgical procedure : hematoma removal with temporal lobectomy(Group I) and hematoma removal only(Group II). GCS score at discharge, GOS score, Barthel index and mortality were compared between the two groups. In overall comparison of GCS score at discharge, GOS score, rate of persistent vegetative state, and death rate between the two groups, there was no significant difference, but among patients with a GCS score 6 and below, this score was higher and the rate of persistent vegetative state and death were lower in Group I than in Group II(p<0.05). Among those with a GCS score of above 6, there was no difference between the two groups. We conclude that for patients whose neurological status is poor(GCS score 6 and below), the benefit of temporal lobectomy in addition to hematoma removal is greater than that of hematoma removal alone.
Basal Ganglia* ; Cerebral Hemorrhage ; Edema ; Hematoma* ; Hemorrhage* ; Humans ; Mortality ; Persistent Vegetative State

Most people presume that the life expectancy of disbled persons after head injury may be shorter than that of the general population. Except for a few specific situations, such as the persistent vegetative state or in patients with a traumatic epilepsy, there are no firm medical evidences to support such a presumption. Furthermore, there are no available guidelines or data for proper estimation of the length of survival for such patients. Estimation based on the limited data or personal experience may cause considerable discrepancies among doctors. The author had reviewed literatures on the life expectancy of disabled or head injured persons, and proposed a scheme or estimation of the life expectancy of disabled persons after head injury. Age and sex of the disabled person, and everity of the disability were used as factors determining the lifespan. This proposal can be a useful reference to estimate the life expectancy of disabled persons after head injury, which will reduce the discrepancy derived from doctors' personal experiences.
Craniocerebral Trauma* ; Disabled Persons* ; Epilepsy, Post-Traumatic ; Head* ; Humans ; Life Expectancy* ; Persistent Vegetative State

Rarely, rupture of a cerebral aneurysm causes an acute subdural hematoma(SDH) in addition to subarachnoid hemorrhage(SAH). We report clinical and radiological characteristics of five cases, as well as potential pitfalls in the diagnosis and the treatment of this life-threatening condition. The patients ranged in age from 42 to 76 years. The Hunt-Hess grade on admission was gradeIII in one patient, gradeIV in two, and grade V in two. All five patients underwent one-stage operation (both SDH evacuation and clipping of the aneurysm). The outcome was good recovery in two patients, persistent vegetative state in two, and death in one. Patients with a good outcome had a better Hunt-Hess grade on admission, with less amount of SDH.
Aneurysm* ; Diagnosis* ; Hematoma, Subdural, Acute* ; Humans ; Intracranial Aneurysm* ; Persistent Vegetative State ; Rupture

Hypertensive intracerebral hemorrhage (ICH) that occurs simultaneously in different sites is an uncommon malady. Moreover, ICH occurring simultaneously in the supra- and infra-tentorial regions is a rare clinical event. A 74-year-old female presented with multiple ICHs and intraventricular hemorrhage, and she displayed a semicomatose mentality. The ICH occurred in the right basal ganglia and the pons extending to the midbrain. Conservative management was performed, and the patient remained in a vegetative state. We report here on a rare case of multiple hypertensive ICH that occurred simultaneously in the supra- and infra-tentorial regions.
Aged ; Basal Ganglia ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Hemorrhage, Hypertensive ; Mesencephalon ; Persistent Vegetative State ; Pons