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2020, Number 3

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Rev Cubana Neurol Neurocir 2020; 10 (3)

Clinical and imaging description of patients with prolonged consciousness disorders

Vargas AGA, Morales CE, Machado CC

Language: Spanish
References: 34
Page: 1-21
PDF size: 502.19 Kb.


ABSTRACT

Objective: To describe clinically and imaging patients with prolonged consciousness disorders.
Methods: An observational, descriptive study was carried out at the Cuban Institute of Neurology and Neurosurgery from January 2015 to December 2018, whose sample was represented by 18 patients. Variables such as age, sex, subtype of prolonged consciousness disorder, etiological diagnosis, time of evolution, presence of hydrocephalus and the degree of cortical, subcortical, thalamic and cerebellar atrophy were taken into account. Descriptive statistics (absolute and relative frequencies) were used.
Results: 66.7% of the cases was found in a chronic vegetative state and 33.3% was in a minimal state of consciousness. Male sex prevailed (55.6%). The main causes were anesthetic accidents and cardiorespiratory arrest, 22.2% in each case, followed by immersion accidents (16.7%). Seventy-five percent of the patients with a chronic vegetative state had severe cortical - subcortical atrophy, while the mild forms predominated in cases with a minimal state of consciousness. Thalamic and cerebellar atrophy was evidenced in 72.2%. Additionally, 83.3% was associated with hydrocephalus.
Conclusions: There was a predominance of young men under 30 years of age with a diagnosis of chronic vegetative state. Postanoxic encephalopathy predominated in patients with chronic vegetative state; while in those with a minimal state of consciousness, there was higher incidence of ischemic vascular causes. The structural neuroimaging revealed severe cortical-subcortical damage in more than half of the patients with chronic vegetative state. In the cases with minimal state of consciousness, there was marked atrophy after 10 years of evolution. Thalamic and cerebellar atrophy occurred in all patients with chronic vegetative state.


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