Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages
Historically, Duret hemorrhages have conferred a devastating prognosis. However, recent case reports suggest that cognitive and functional recovery are possible after Duret hemorrhages. Here, we describe a patient who recovered consciousness, communication, and functional independence after Duret he...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-10-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.01077/full |
| _version_ | 1828305693410590720 |
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| author | Brian L. Edlow Brian L. Edlow Zachary D. Threlkeld Katie P. Fehnel Yelena G. Bodien Yelena G. Bodien |
| author_facet | Brian L. Edlow Brian L. Edlow Zachary D. Threlkeld Katie P. Fehnel Yelena G. Bodien Yelena G. Bodien |
| author_sort | Brian L. Edlow |
| collection | DOAJ |
| description | Historically, Duret hemorrhages have conferred a devastating prognosis. However, recent case reports suggest that cognitive and functional recovery are possible after Duret hemorrhages. Here, we describe a patient who recovered consciousness, communication, and functional independence after Duret hemorrhages caused by traumatic transtentorial herniation. We performed prospective, standardized behavioral assessments, structural MRI scans and stimulus-based functional MRI (fMRI) scans during the first 2 years of recovery. The multimodal assessments revealed reintegration of neural networks mediating language and consciousness, concurrent with the reemergence of functional independence. These observations provide insights into network-based mechanisms of recovery from coma and add to a growing body of evidence indicating that Duret hemorrhages are not invariably associated with a poor prognosis. |
| first_indexed | 2024-04-13T14:33:14Z |
| format | Article |
| id | doaj.art-c7669195dde446a680d29c91db23d648 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T14:33:14Z |
| publishDate | 2019-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c7669195dde446a680d29c91db23d6482022-12-22T02:43:08ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-10-011010.3389/fneur.2019.01077474321Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret HemorrhagesBrian L. Edlow0Brian L. Edlow1Zachary D. Threlkeld2Katie P. Fehnel3Yelena G. Bodien4Yelena G. Bodien5Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United StatesDepartment of Neurology and Neurological Sciences, Stanford School of Medicine, Stanford, CA, United StatesDepartment of Neurosurgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, United StatesDepartment of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United StatesDepartment of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, United StatesHistorically, Duret hemorrhages have conferred a devastating prognosis. However, recent case reports suggest that cognitive and functional recovery are possible after Duret hemorrhages. Here, we describe a patient who recovered consciousness, communication, and functional independence after Duret hemorrhages caused by traumatic transtentorial herniation. We performed prospective, standardized behavioral assessments, structural MRI scans and stimulus-based functional MRI (fMRI) scans during the first 2 years of recovery. The multimodal assessments revealed reintegration of neural networks mediating language and consciousness, concurrent with the reemergence of functional independence. These observations provide insights into network-based mechanisms of recovery from coma and add to a growing body of evidence indicating that Duret hemorrhages are not invariably associated with a poor prognosis.https://www.frontiersin.org/article/10.3389/fneur.2019.01077/fullDuret hemorrhagecomatraumatic brain injurybrainstemherniation |
| spellingShingle | Brian L. Edlow Brian L. Edlow Zachary D. Threlkeld Katie P. Fehnel Yelena G. Bodien Yelena G. Bodien Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages Frontiers in Neurology Duret hemorrhage coma traumatic brain injury brainstem herniation |
| title | Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages |
| title_full | Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages |
| title_fullStr | Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages |
| title_full_unstemmed | Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages |
| title_short | Recovery of Functional Independence After Traumatic Transtentorial Herniation With Duret Hemorrhages |
| title_sort | recovery of functional independence after traumatic transtentorial herniation with duret hemorrhages |
| topic | Duret hemorrhage coma traumatic brain injury brainstem herniation |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.01077/full |
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