Awakenings from persistent vegetative state: report of three cases with parkinsonism and brain stem lesions on MRI.
Three patients with a persistent vegetative state after severe head injury are reported. They recovered from a prolonged disturbance of consciousness after the administration of levodopa. These patients all had parkinsonian features. On magnetic resonance imaging, the distribution of lesions implied a diffuse axonal injury involving the substantia nigra or ventral tegmental area. The existence of patients whose dopaminergic systems may have been selectively damaged by a severe head injury should be recognised because such individuals may respond to levodopa treatment.
Matsuda
W
W
Department of Neurosurgery, Tsukuba Medical Centre Hospital, Ibaraki, Japan. wako@mua.biglobe.ne.jp
Matsumura
A
A
Komatsu
Y
Y
Yanaka
K
K
Nose
T
T
D000293:Adolescent; D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001933:Brain Stem / Q000473:pathology*; D006259:Craniocerebral Trauma / Q000150:complications*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000188:drug therapy* / Q000209:etiology*; D018458:Persistent Vegetative State / Q000188:drug therapy* / Q000473:pathology*; D011954:Receptors, Dopamine; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D011954:Receptors, Dopamine; D007980:Levodopa