Chapter 7. Assessment of Severe Damage to the Brain by Multiregional Measurements of Cerebral Blood Flow

  1. Ruth Porter and
  2. David W. Fitzsimons
  1. David H. Ingvar and
  2. Manuel Gadea Ciria

Published Online: 30 MAY 2008

DOI: 10.1002/9780470720165.ch7

Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System

Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System

How to Cite

Ingvar, D. H. and Ciria, M. G. (1975) Assessment of Severe Damage to the Brain by Multiregional Measurements of Cerebral Blood Flow, in Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System (eds R. Porter and D. W. Fitzsimons), John Wiley & Sons, Ltd., Chichester, UK. doi: 10.1002/9780470720165.ch7

Author Information

  1. Department of Clinical Neurophysiology, University Hospital, Lund

Publication History

  1. Published Online: 30 MAY 2008
  2. Published Print: 1 JAN 1975

ISBN Information

Print ISBN: 9789021940380

Online ISBN: 9780470720165

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Keywords:

  • cerebral blood flow;
  • persistent vegetative state;
  • multiregional measurements;
  • cutaneous electric stimulation;
  • behavioural responses

Summary

Regional cerebral blood flow (rCBF) was measured with a 32-detector device in patients with severe injury to the central nervous system. Most had suffered head injuries in traffic accidents. Many patients were severely demented. Several were comatose or in a so-called persistent vegetative state. Flow was measured at rest and during various forms of stimulation. The resting values were on the whole markedly reduced. The flow patterns often showed distinct correlations with the original brain injury. In the best preserved patients, mental activation caused increases in flow with a normal or near-normal distribution. Cutaneous electric stimulation gave rise to increases in cortical flow even in highly reduced patients with severe brain damage. Patients with total or less than total loss of telencephalic structures with retained brainstem reflexes and respiration (‘apallic’ patients) did not show any changes in flow on sensory stimulation. We conclude that the technique for measuring rCBF enables us to assess severe damage to the central nervous system quantitatively and also to estimate whether higher functions are retained in severely reduced patients in coma, stupor and apallic state—patients who more or less completely lack behavioural responses.