A young man was resuscitated from a deep
comatose state following unobserved cardiac
arrest. Head CT done a few hours later revealed
bilateral basal ganglia hypodensities,
suggestive of hypoxic-ischemic brain damage
(figure 1).
Six months post-resuscitation, the patient
had spontaneous eye movements, chewing, and
yawning, but
no purposeful movement on verbal or visual
stimuli. Repeat head CT (figure 2) revealed
grossly shrunken residual brain parenchyma,
correlating with clinical picture of persistent
vegetative state, a term introduced by Jennett
and Plum to describe a state of continuing
"wakefulness without awareness."
The common causes of persistent vegetative
state include head injury and hypoxic ischemic
damage.
1. Jennett B, Plum F. Persistent vegetative
state after brain damage. Lancet
1972;i:234-237.
2. The Multi Society Task Force on PVS.
Medical aspects of the persistent vegetative
state (Part I). N EngI j Med
1994;330:14991508.
