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Neuropathological Findings in the Brain of Karen Ann Quinlan
NEJM 330:1469-1475, Kinney,H.C.,et al, 1994
See this aricle in Pubmed
Article Abstract
Contrary to expectation,the most severe damage was not in the cerebral cortex but in the thalamus,and the brain stem was relatively intact.The neuropathological findings included extensive bilateral thalamic scarring, bilateral cortical scars primarily in the occipital pole and parasagittal parieto-occipital region,and bilateral damage to cerebellar and focal- basal-ganglia regions.The brain stem and basal forebrain and the hypothalamic components of the ascending arousal systems and brainstem regions critical to cardiac and respiratory control were undamaged.The lesions were consistent with hypoxia-ischemia after the cardiopulmonary arrest.Although the neuropathological findings in the case of Karen Ann Quinlan were complex,the disproportionately severe damage in the thalamus as compared with the cerebral cortexs supports the hypothesis that the thalamus is critical for cognition and awareness and may be less essential for arousal.
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arousal
awareness
cognition
hypoxia
hypoxic encephalopathy
neuropathology
neuropathology,brain
persistent vegetative state
thalamus,lesion of
thalamus,lesion of-bilateral
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