title: Recovery of consciousness and an injured ascending reticular activating system in a patient who survived cardiac arrest: A case report.
abstract: We report on a patient who survived cardiac arrest and showed recovery of consciousness and an injured ARAS at the early stage of hypoxic-ischemic brain injury (HI- BI) for 3 weeks, which was demonstrated by diffusion tensor tractography (DTT).A 52-year-old male patient who had suffered cardiac arrest caused by acute coronary syndrome was resuscitated immediately by a layman and paramedics for ∼25 minutes. He was then transferred immediately to the emergency room of a local medical center. When starting rehabilitation at 2 weeks after onset, his consciousness was impaired, with a Glasgow Coma Scale (GCS) score of 8 and Coma Recovery Scale-Revised (GRS-R) score of 8. He underwent comprehensive rehabilitative therapy, including drugs for recovery of consciousness. He recovered well and rapidly so that his consciousness had recovered to full scores in terms of GCS:15 and GRS-R:23 at 5 weeks after onset.The left lower dorsal and right lower ventral ARAS had become thicker on 5-week DTT compared with 2-week DTT (Fig. 1B). Regarding the change of neural connectivity of the thalamic ILN, increased neural connectivity to the basal forebrain and prefrontal cortex was observed in both hemispheres on 5-week DTT compared with 2-week DTT.Recovery of an injured ARAS was demonstrated in a patient who survived cardiac arrest and his consciousness showed rapid and good recovery for 3 weeks at the early stage of HI-BI.
authors.affiliation: aDepartment of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea, bThe Department of Diagnostic Radiology, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Jang
authors.forename: Yi Ji
authors.initials: YJ
authors.lastname: Hyun
authors.forename: Han Do
authors.initials: HD
authors.lastname: Lee
mesh_terms: D003243:Consciousness; D056324:Diffusion Tensor Imaging; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000150:complications / Q000523:psychology*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012154:Reticular Formation / Q000473:pathology