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July 1970

Destruction of the Reticular Core of the Brain Stem: A Patho-anatomical Follow-Up of a Case of Coma of Three Years' Duration

Author Affiliations

Lund, Sweden
From the Neuropathological Laboratory, Department of Pathology I, University of Gothenburg, and the Department of Clinical Neurophysiology, University Hospital, Lund, Sweden.

Arch Neurol. 1970;23(1):1-8. doi:10.1001/archneur.1970.00480250005001

THIS is a patho-anatomical follow-up study of a patient who died following a period of coma lasting nearly three years (35 months) due to a vascular lesion of the brain stem. About 18 months following the onset of coma, in 1964, the patient underwent a thorough special study, and the clinical findings at this stage, including measurements of the cerebral blood flow and metabolism, were published.1 The justification for this further report is twofold. First, comatose states of long duration due to more or less selective lesions of the mesencephalic reticular formation are rare indeed. Such cases may provide information about the role of the reticular system in sustaining the conscious state. Second, as far as we are aware, the present case is the only one in which detailed physiological observations of cerebral activity during the period of coma have been correlated with subsequent necropsy findings. The microscopic

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