Scientific reports · 2019
Deep structural brain lesions associated with consciousness impairment early after hemorrhagic stroke.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАПоддержка правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Rohaut Benjamin, Doyle Kevin W, Reynolds Alexandra S, Igwe Kay, Couch Caroline, Matory Adu, Rizvi Batool, Roh David, Velazquez Angela, Megjhani Murad, Park Soojin, Agarwal Sachin, Mauro Christine M, Li Gen, Eliseyev Andrey, Perlbarg Vincent, Connolly Sander, Brickman Adam M, Claassen Jan
Аннотация
The purpose of this study was to determine the significance of deep structural lesions for impairment of consciousness following hemorrhagic stroke and recovery at ICU discharge. Our study focused on deep lesions that previously were implicated in studies of disorders of consciousness. We analyzed MRI measures obtained within the first week of the bleed and command following throughout the ICU stay. A machine learning approach was applied to identify MRI findings that best predicted the level consciousness. From 158 intracerebral hemorrhage patients that underwent MRI, one third was unconscious at the time of MRI and half of these patients recovered consciousness by ICU discharge. Deep structural lesions predicted both, impairment and recovery of consciousness, together with established measures of mass effect. Lesions in the midbrain peduncle and pontine tegmentum alongside the caudate nucleus were implicated as critical structures. Unconscious patients predicted to recover consciousness by ICU discharge had better long-term functional outcomes than those predicted to remain unconscious.