Accelerated emergence from a nontraumatic minimally conscious state with levodopa/carbidopa

Ernesto Bancalari, Alejandro Rabinstein, Francisco Machiavello, Alejandro Desmaison

Research output: Contribution to journalArticle

Abstract

A 62-year-old woman was admitted to our hospital in coma following the nontraumatic rupture of a left posterior inferior cerebellar artery aneurysm with subsequent intraventricular hemorrhage and acute hydrocephalus, affecting mainly the fourth ventricle with substantial adjacent edema (figure 1). Her Glasgow Coma Scale score was 3/15 and physical examination showed left hemiparesis, absent corneal and oculovestibular reflexes. Dexamethasone (4 mg q6h) and mannitol (1 g/kg initially, then 0.5 mg/kg q6h) were started, and a frontal bilateral trephination with external ventricular drainage was performed. Initial sedation was waned and discontinued 7 days later. The right and left ventricular drains were removed 9 and 15 days after placement, respectively, when a head CT scan showed reduction of the intraventricular hemorrhage and hydrocephalus (figure 2). Transcranial Doppler on days 2 and 8 showed no vasospasm. Serial EEGs on days 14, 21, and 28 showed no ictal activity. The aneurysm was successfully embolized 34 days after admission.

Original languageEnglish (US)
Pages (from-to)541-542
Number of pages2
JournalNeurology: Clinical Practice
Volume8
Issue number6
DOIs
StatePublished - Dec 1 2018

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Persistent Vegetative State
Hydrocephalus
Aneurysm
Trephining
Hemorrhage
Fourth Ventricle
Abnormal Reflexes
Glasgow Coma Scale
Mannitol
Paresis
Coma
Dexamethasone
Physical Examination
Rupture
Drainage
Electroencephalography
Edema
Arteries
Stroke
Head

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Accelerated emergence from a nontraumatic minimally conscious state with levodopa/carbidopa. / Bancalari, Ernesto; Rabinstein, Alejandro; Machiavello, Francisco; Desmaison, Alejandro.

In: Neurology: Clinical Practice, Vol. 8, No. 6, 01.12.2018, p. 541-542.

Research output: Contribution to journalArticle

Bancalari, Ernesto ; Rabinstein, Alejandro ; Machiavello, Francisco ; Desmaison, Alejandro. / Accelerated emergence from a nontraumatic minimally conscious state with levodopa/carbidopa. In: Neurology: Clinical Practice. 2018 ; Vol. 8, No. 6. pp. 541-542.
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