Long-Lasting Post-Traumatic Unconsciousness

Bricolo, Albino; Gentilomo, A.; Rosadini, G; Gf, Rossi

doi:10.1111/j.1600-0404.1968.tb05589.x

Cited by 38 publications

(7 citation statements)

References 21 publications

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“…EEG reco rdi ngs were obrained in pa tient s, 1,6, and 12 monrhs after recover y frorn seve re head tr auma wir h sign s of bra in ste rn d ysfun ct io n.. M odification s of intra-sleep wa kefulness (W .) and REM sleep were ob served bu t none of slo w wave sleep (SW S).…”

mentioning

confidence: 99%

Twelve months follow-up by night sleep EEG after recovery from severe head trauma

George¹,

Landau-Ferey²

1986

Minim Invasive Neurosurg

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Night sleep EEG recordings were obtained in patients, 1, 6, and 12 months after recovery from severe head trauma with signs of brain stem dysfunction. Modifications of intra-sleep wakefulness (W.) and REM sleep were observed but none of slow wave sleep (SWS). At one month after regaining consciousness, the lower the initial level of brain stem dysfunction, the greater the sleep disturbances were. At six months, improvement was observed. At one year, sleep disturbances increased again mainly in patients between 35 and 45 years old. These results are best compared to those observed in normal but elderly people, over 70 years.

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confidence: 99%

Twelve months follow-up by night sleep EEG after recovery from severe head trauma

George¹,

Landau-Ferey²

1986

Minim Invasive Neurosurg

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“…The prolonged recordings taken by us did not last longer than 4 h. Certainly, therefore, the information obtained is less than could have been derived from overnight or 24-hour recordings [2,4,17], However, since record ings were regularly repeated over time, they enabled us to analyze the development of the CAP as the neuropsychologic functions were being progressively recovered and the organi zation of the levels of arousal was becoming gradually normal. The role played in progno sis by the presence of CAP as an immediate consequence of head injury is an uncertain one [1], Only its development over the fol lowing days might provide indications as to the eventual outcome of coma.…”

Section: Discussionmentioning

confidence: 99%

“…The role played in progno sis by the presence of CAP as an immediate consequence of head injury is an uncertain one [1], Only its development over the fol lowing days might provide indications as to the eventual outcome of coma. The persis tence of CAP or its conversion into a pattern with no spontaneous or elicited reactivity, within 3 weeks of the injury, are in turn a feature suggesting a poor prognosis [29], Ac cording to Bricolo et al [7], the fluctuating two-phase pattern may turn, around the 4th day, into a monotonous slow pattern or else it may take on some features that are typical of sleep [9], In particular, bursts of 8-14 c/s waves which resemble the spindles of stage-II sleep coexist with CAP in 38% of discontin uous recordings [7], In prolonged night re cordings, alongside subjects who suffer from an absolute lack of any of the sleep compo nents, other subjects show sleep cycles either complete or incomplete because of the ab sence of REM sleep or of some stages in slowwave sleep [2,4], In the recordings taken by us. we saw that a correct organization of the sleep cycles was being recovered progressive ly, and that the reappearance of REM sleep took place after non-REM sleep.…”

Section: Discussionmentioning

confidence: 99%

“…Although in co matose cases clinical semeiology is supposed to play a major role [6. 35], the presence of CAP is of great importance especially in the evaluation of post-traumatic comas [2,4,11,29], The evolution of CAP on EEG, however, is still uncertain and its prognostic value is therefore limited [ 1 ]. The appearance of sleep patterns or sleep-like patterns, on the con trary.…”

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confidence: 99%

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Is the EEG Cyclic Alternating Pattern a True Autonomous Entity?

Terzano¹,

Gatti²,

Manzoni³

et al. 1982

Eur Neurol

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The cyclic alternating pattern (CAP) characterizes stage-II coma according to Fischgold and Mathis. Its evolution and prognostic value are still uncertain. An analytic investigation of CAP and its components (phase A of greater arousal and phase B of lesser arousal) was conducted on a patient with post-traumatic coma who completely recovered. The relationships between this type of pattern and the stages of physiologic sleep were investigated during four prolonged night recordings taken at regular intervals. The evolution of CAP in post-traumatic coma is compared with the development of CAP observed in Creutz-feldt-Jakob disease. The hypothesis is suggested that CAP may be related to other cyclic phenomena, especially the Lundberg B-type CSF pressure waves. According to this assumption, in a coma with CAP, mechanisms for the organization of arousal, which are not known but persist up to the threshold of death, could still be acting. In sleep these same mechanisms are supposed to be integrated with others, more sophisticated and less resistant to pathogenic injuries.

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“…Even mild TBI can be associated with headache, dizziness, nausea/vomiting, impaired balance and coordination, vision changes, tinnitus, mood and memory changes, difficulty with memory and attention, and fatigue and/or sleep disturbances. (3) The relationship between head trauma and impaired consciousness and cognitive disturbance have been well described,(4) but the association between head injury and sleep disturbance has not been extensively studied. (Table 1)…”

Section: Introductionmentioning

confidence: 99%

Traumatic Brain Injury and Sleep Disorders

2012

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SYNOPSIS Sleep disturbance is common following traumatic brain injury (TBI), affecting 30–70% of individuals, many occurring after mild injuries. Insomnia, fatigue and sleepiness are the most frequent post-TBI sleep complaints with narcolepsy (with or without cataplexy), sleep apnea (obstructive and/or central), periodic limb movement disorder, and parasomnias occurring less commonly. In addition, depression, anxiety and pain are common TBI co-morbidities with substantial influence on sleep quality. Two types of TBI negatively impact sleep: contact injuries causing focal brain damage and acceleration/deceleration injuries causing more generalized brain damage. Diagnosis of sleep disorders after TBI may involve polysomnography, multiple sleep latency testing and/or actigraphy. Treatment is disorder specific and may include the use of medications, continuous positive airway pressure (or similar device) and/or behavioral modifications. Unfortunately, treatment of sleep disorders associated with TBI often does not improve sleepiness or neuropsychological function.

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Long-Lasting Post-Traumatic Unconsciousness

Cited by 38 publications

References 21 publications

Twelve months follow-up by night sleep EEG after recovery from severe head trauma

Twelve months follow-up by night sleep EEG after recovery from severe head trauma

Is the EEG Cyclic Alternating Pattern a True Autonomous Entity?

Traumatic Brain Injury and Sleep Disorders

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