• Medicine · Mar 2021

    Case Reports

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

    • Sung Ho Jang, Seong Ho Kim, and Jeong Pyo Seo.
    • Department of Physical Medicine and Rehabilitation.
    • Medicine (Baltimore). 2021 Mar 5; 100 (9): e23933e23933.

    AbstractWe 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.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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