Recovery of Hypersomnia Concurrent With Recovery of an Injured Ascending Reticular Activating System in a Stroke Patient: A Case Report

Medicine
Sung Ho JangYoung Jin Jung

Abstract

We report on a stroke patient who showed recovery of hypersomnia concurrent with the recovery of an injured ascending reticular activating system (ARAS), which was demonstrated by diffusion tensor tractography (DTT).A 70-year-old female patient underwent coiling of the left ruptured posterior communicating artery after subarachnoid hemorrhage and both extraventricular drainage for management of an intraventricular hemorrhage. At 2 months after onset, when she started rehabilitation, she exhibited intact consciousness, with the full score on the Glasgow Coma Scale: 15. However, she showed severe hypersomnia: she always fell asleep without external stimulation and the Epworth Sleepiness Scale (EPS) score was 24 (full score: 24, cut off for hypersomnia: 10). She underwent comprehensive rehabilitative therapy, including neurotropic drugs, physical therapy, and occupational therapy. Her hypersomnia has shown improvement as 14 (3 months after onset), 11 (4 months after onset), 7 (12 months after onset), and 6 (24 months after onset), respectively.On 2-month DTT, narrowing of both lower dorsal and ventral ARASs was observed on both sides: in particular, among 4 neural tracts of the lower ARAS, the right lower ventral ARAS was the narr...Continue Reading

References

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Feb 6, 2016·Sleep Medicine·Sung Ho JangHyeok Gyu Kwon

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Citations

Aug 22, 2017·American Journal of Physical Medicine & Rehabilitation·Sung Ho Jang, Hyeok Gyu Kwon
May 30, 2017·Neural Regeneration Research·Sung Ho Jang, Han Do Lee
Feb 7, 2020·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Ardalan SharifiAndrew G Lee

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Software Mentioned

FMRIB Diffusion
Oxford Centre for Functional Magnetic Resonance Imaging of the...

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