Rare Diseases Symptoms Automatic Extraction
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A random Abstract
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PET in coma and in vegetative state.
[locked-in syndrome]
Advances
in
resuscitation
and
critical
care
management
have
resulted
in
the
survival
of
many
patients
despite
severe
brain
damage
.
These
patients
may
remain
in
coma
or
in
vegetative
state
.
The
probability
of
recovery
of
conscious
function
is
dependent
on
the
extent
of
structural
brain
damage
,
which
is
difficult
to
assess
by
clinical
,
laboratory
or
functional
tests
.
Positron
emission
tomography
(
PET
)
of
18
F-
fluordeoxyglucose
(
FDG
)
can
be
used
to
investigate
metabolic
and
functional
impairment
of
the
brain
.
In
acute
vegetative
state
(
AVS
,
duration
<
1
month
)
,
overall
glucose
utilization
was
significantly
reduced
in
comparison
with
age-matched
controls
.
In
a
few
cases
with
locked-
in
syndrome
,
cortical
metabolism
was
in
the
normal
range
.
11
C-Flumazenil
(
FMZ
)
measures
the
density
of
benzodiazepine
receptors
(
BZRs
)
and
thereby
furnishes
an
estimate
of
neuronal
integrity
.
PET
with
this
tracer
demonstrated
a
considerable
reduction
in
BZRs
in
cortical
areas
,
but
indicated
that
the
cerebellum
was
spared
from
neuronal
loss
.
The
comparison
of
FDG-
and
FMZ-PET
findings
in
AVS
demonstrates
that
alterations
of
cerebral
glucose
consumption
do
not
represent
mere
functional
inactivation
,
but
also
irreversible
structural
damage
.
In
some
cases
with
minimally
conscious
state
,
auditory
stimuli
with
emotional
valence
induced
more
brain
activation
(
investigated
by
H
215
O-PET
)
than
meaningless
noise
;
such
studies
can
be
used
to
detect
residual
cortical
function
.
To
improve
prognostication
of
chances
for
recovery
,
a
combination
of
functional
activation
studies
and
assessment
of
the
extent
of
neuronal
damage
might
be
the
optimal
procedure
and
should
be
tested
in
larger
cohorts
of
patients
with
comatose
states
of
different
severity
.
