patient with only brain stem function prognosis

The present study aimed to identify chief predictors of survival and consciousness after PBSH.Īll patients' clinical data were reviewed including general characteristics (age, sex, smoking or drinking habits, previous functional status, and comorbidities), clinical characteristics upon admission (vital signs, blood pressure, pupillary abnormalities, GCS score, and emergency treatment), laboratory data, radiological findings upon admission or during hospitalization, treatment, and outcomes. Here, we conducted a retrospective, observational, explorative, and single-center study to analyze the prognostic factors affecting the 30-day survival rate and the 90-day consciousness rate in 211 patients with PBSH undergoing conservative or stereotactic aspiration therapy. Accordingly, studies on PBSH treatments related to death or a better outcome are useful in clinical practice. The option of PBSH treatments including conservative treatment or stereotactic surgery remains quite challenging for neurosurgeons. Computed tomography (CT)-guided stereotactic hematoma puncture and drainage provided a potential treatment for PBSH, which showed a more favorable outcome than conservative therapy ( 12, 13). The number of patients with PBSH who underwent surgery enrolled in previous studies has been relatively small, and most studies date back to more than 20 years. However, others have advocated the efficacy of surgical treatment for PBSH or other brainstem diseases ( 10, 11). The American Heart Association/American Stroke Association Guidelines clearly advise against the surgical evacuation of brainstem hematoma ( 9). Neurosurgical interventions continue to be controversial and have not been sufficiently investigated because ICH in the posterior fossa has been excluded from large ICH surgical intervention trials in the past ( 7, 8). Currently, there is no standard, widely accepted prognostic model or clinical grading scale for survival and consciousness outcomes, and there are no strong recommendations for clinical treatment strategies for PBSH. Previous studies have found that the severity of initial neurological symptoms, hydrocephalus, hematoma volume, and GCS score may be predictors of poor outcomes for patients with PBSH ( 5, 6), but the conclusions of different studies are not uniform. PBSH is known to have a poor prognosis, with a mortality rate varying widely from 70 to 80% ( 2, 3), and the 30-day mortality rate for patients with a Glasgow Coma Scale (GCS) score of 10 ml even reaches 100% ( 4). All rights reserved.Primary brainstem hemorrhage (PBSH) is one of the most catastrophic spontaneous intracerebral hemorrhage (ICH) diseases, which accounts for approximately 3.8–6.3% of ICH cases ( 1). Increases in FC and ALFF values in the DMN are related to better prognosis in patients with sTBI.ĭefault mode network Prognosis Resting-state fMRI Severe traumatic brain injury.Ĭopyright © 2018 Elsevier Inc.

Increased ALFF values in the right frontal gyrus, right temporal gyrus, and right inferior parietal gyrus were significant in the conscious subgroup compared with the coma subgroup. The conscious subgroup showed significantly enhanced FC in the medial superior frontal gyrus, left temporal gyrus, anterior cingulate gyrus, precuneus, posterior cingulate gyrus, and parietal cortex compared with the coma subgroup. However, patients with a better prognosis showed a significant increase in FC and ALFF values in the DMN. Patients with sTBI showed significantly decreased FC and ALFF values in the DMN. We further assessed and compared the FC and ALFF values in both groups. FC and ALFF values were measured in the DMN and compared between the groups. Of the 21 patients with sTBI, 12 patients regained consciousness (Glasgow Outcome Scale score >2) and 9 patients remained unconscious (GOS score <2). Twenty-one healthy sex-, age-, and education-matched control subjects were recruited for the control group. Twenty-one patients with sTBI were included.

We investigate the change of the default mode network (DMN) by using amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) methods in acute phase patients after severe traumatic brain injury (sTBI) and correlate these changes with prognosis.

Patient with only brain stem function prognosis