Return to Alertness After Brain-Stem Hemorrhage: A Case with Evoked Potential and Roentgenographic Evidence of Bilateral Tegmental Damage

Russell K. Portenoy, Diane Kurtzberg, Joseph C. Arezzo, George H. Sands, Ann Miller, Herbert G. Vaughan

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Abstract

After a 65-year-old man had received anticoagulation therapy for brain-stem ischemia, a large, bilateral pontomesencephalic hemorrhage developed in the ischemic region. He survived a period of being “locked in” to attain a limited functional recovery. When he first became alert, brain-stem auditory evoked potentials and short-latency somatosensory evoked potentials (SEPs) demonstrated bilateral brain-stem damage; computed tomography revealed a bilateral tegmental hematoma. Results of repeated studies changed little as clinical improvement occurred. Recovery from brain-stem hemorrhage is rare, and return of consciousness with bilateral tegmental involvement is even more rare. The shortlatency SEPs are useful in defining the extent of brain-stem damage, but they evaluate structures distinct from those regulating consciousness and cannot predict a return to alertness.

Original languageEnglish (US)
Pages (from-to)85-88
Number of pages4
JournalArchives of Neurology
Volume42
Issue number1
DOIs
Publication statusPublished - Jan 1985

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ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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