Abstract:
: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.
journal_name
Sci Repjournal_title
Scientific reportsauthors
Rohaut B,Doyle KW,Reynolds AS,Igwe K,Couch C,Matory A,Rizvi B,Roh D,Velazquez A,Megjhani M,Park S,Agarwal S,Mauro CM,Li G,Eliseyev A,Perlbarg V,Connolly S,Brickman AM,Claassen Jdoi
10.1038/s41598-019-41042-2subject
Has Abstractpub_date
2019-03-12 00:00:00pages
4174issue
1issn
2045-2322pii
10.1038/s41598-019-41042-2journal_volume
9pub_type
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