Recovery of consciousness after a brainstem cavernous malformation hemorrhage: A descriptive study of preserved reticular activating system with tractography

Edgar G. Ordóñez-Rubiano, Jason Michael Johnson, Iyan Younus, Mauricio J. Avila, Pierre Y. Fonseca-Mazeau, Jorge H. Marín-Muñoz, William Cortes-Lozano, César O. Enciso-Olivera, Edgar G. Ordóñez-Mora

Research output: Contribution to journalArticle

Abstract

The aim of this study is to describe the imaging features, the relevant anatomy, and the fractional anisotropy (FA) values in diffusion tensor tractography (DTT) of the ascending reticular activating system (ARAS) fiber tracts in 2 patients who recovered from initial altered consciousness after presenting with a brainstem cavernous malformation (BSCM) hemorrhage. A DTT was performed in 2 patients with impaired consciousness after a brainstem cavernous malformation hemorrhage. A 1.5 T scanner was used to obtain the axial tensors. Post-processing was performed and the mean FA values were recorded. The FA maps were used to seed the following regions of interest: the ventromedial midbrain, the anterior thalamus bilaterally, and the hypothalamus bilaterally. The first case presented with posterior displacement of the dorsal raphè fiber tracts, with preservation of all the ascending reticular activating fiber tracts and spontaneous recovery of consciousness after 20 days. The second case presented with no destruction but also had posterior displacement of the inferior dorsal raphè fiber tracts, with recovery of consciousness 1 month after resection surgery. Described in this study are affected fibers of the ARAS, as well as the FA value abnormalities in 2 patients, with recovery of a transient disorder of consciousness after a BSCM hemorrhage.

Original languageEnglish (US)
Pages (from-to)372-377
Number of pages6
JournalJournal of Clinical Neuroscience
Volume59
DOIs
StatePublished - Jan 1 2019

Fingerprint

Anisotropy
Consciousness
Brain Stem
Hemorrhage
Reticulin
Diffusion Tensor Imaging
Anterior Thalamic Nuclei
Consciousness Disorders
Mesencephalon
Hypothalamus
Anatomy
Seeds

Keywords

  • Arousal
  • Ascending reticular activating system
  • Brainstem
  • Cavernous malformation
  • Consciousness
  • Diffusion tensor imaging
  • Tractography

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Recovery of consciousness after a brainstem cavernous malformation hemorrhage : A descriptive study of preserved reticular activating system with tractography. / Ordóñez-Rubiano, Edgar G.; Johnson, Jason Michael; Younus, Iyan; Avila, Mauricio J.; Fonseca-Mazeau, Pierre Y.; Marín-Muñoz, Jorge H.; Cortes-Lozano, William; Enciso-Olivera, César O.; Ordóñez-Mora, Edgar G.

In: Journal of Clinical Neuroscience, Vol. 59, 01.01.2019, p. 372-377.

Research output: Contribution to journalArticle

Ordóñez-Rubiano, EG, Johnson, JM, Younus, I, Avila, MJ, Fonseca-Mazeau, PY, Marín-Muñoz, JH, Cortes-Lozano, W, Enciso-Olivera, CO & Ordóñez-Mora, EG 2019, 'Recovery of consciousness after a brainstem cavernous malformation hemorrhage: A descriptive study of preserved reticular activating system with tractography', Journal of Clinical Neuroscience, vol. 59, pp. 372-377. https://doi.org/10.1016/j.jocn.2018.10.074
Ordóñez-Rubiano, Edgar G. ; Johnson, Jason Michael ; Younus, Iyan ; Avila, Mauricio J. ; Fonseca-Mazeau, Pierre Y. ; Marín-Muñoz, Jorge H. ; Cortes-Lozano, William ; Enciso-Olivera, César O. ; Ordóñez-Mora, Edgar G. / Recovery of consciousness after a brainstem cavernous malformation hemorrhage : A descriptive study of preserved reticular activating system with tractography. In: Journal of Clinical Neuroscience. 2019 ; Vol. 59. pp. 372-377.
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