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Frontal blood flow changes in recovery from coma.

G Deutsch, H M Eisenberg

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism

|February 1, 1987

Summary

Comatose patients with head injuries exhibit reduced frontal blood flow, often with a reversed flow gradient. This frontal blood flow normalizes upon recovery, suggesting it reflects reduced mental activity.

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Area of Science:

Neuroscience
Neurology
Medical Imaging

Background:

Cortical blood flow (CBF) changes are critical indicators of brain function.
Understanding CBF alterations in traumatic brain injury (TBI) is essential for prognosis and treatment.
Previous studies suggest frontal CBF reduction in various conditions.

Purpose of the Study:

To investigate two-dimensional cortical blood flow patterns in patients with closed head injuries.
To compare CBF in comatose TBI patients with their recovered state and with healthy volunteers.
To determine if frontal CBF reduction is linked to injury location or a more general state of reduced mental activity.

Main Methods:

Two-dimensional cortical blood flow studies were performed on 20 comatose head injury patients.
CBF was reassessed in 9 patients as they recovered to an awake state.
Flow patterns were compared to age-matched normal volunteers and correlated with CT scan data.

Main Results:

Comatose patients displayed reduced frontal blood flow compared to controls.
The typical anterior-to-posterior flow gradient was reversed in most comatose patients.
Recovered patients showed normalization of regional flow patterns.
Frontal blood flow reduction was independent of the injury's location on CT scans.

Conclusions:

Reduced frontal blood flow in head injury patients is a significant finding.
The observed frontal blood flow reduction appears to be a nonspecific effect of reduced directed mental activity, not solely related to TBI.
These findings challenge existing interpretations of frontal CBF reduction in psychiatric disorders.

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