Early and late CT manifestations in the persistent vegetative state due to cerebral anoxia-ischemia

Although there are reports on early CT findings in the persistent vegetative state (PVS) from cerebral anoxia-ischemia, later CT changes have received little attention. CT scans were obtained from six patients who were in PVS from four months to three years. Initial CT scans showed non-specific changes of diffuse cerebral edema. Later CT findings often showed infarction in the superficial or deep border zones (five patients), low density in the basal ganglia (four patients), and infarction in the posterior cerebral artery (PGA) territory (three patients). When the survival time extended beyond eight months, there was an enormous enlargement of the hemispheric ventricles that was disproportionate to the cortical atrophy. The data indicate that border zone and PCA territory infarctions are common in PVS. A progressive, and eventually significant loss of the cerebral mass seems to occur in long-term survivors.