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Research ArticleBrain
Open Access

Aneurysmal Subarachnoid Hemorrhage Causes Injury of the Ascending Reticular Activating System: Relation to Consciousness

S.H. Jang and H.S. Kim
American Journal of Neuroradiology April 2015, 36 (4) 667-671; DOI: https://doi.org/10.3174/ajnr.A4203
S.H. Jang
aFrom the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
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H.S. Kim
aFrom the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea.
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    Fig 1.

    Brain CT (left) showing subarachnoid hemorrhage at onset and diffusion tensor tractography of the ascending reticular activating system between the pontine reticular formation and the intralaminar thalamic nuclei (right) in 2 patients (A, A 69-year-old woman, Glasgow Coma Scale score, 11; and B, A 57-year-old woman, Glasgow Coma Scale score, 15).

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    Fig 2.

    Correlation between the Glasgow Coma Scale score and fractional anisotropy (A), apparent diffusion coefficient (B), and tract number (C) of patients with subarachnoid hemorrhage on the more affected side, the less affected side, and both sides.

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    Table 1:

    Demographic and clinical data of patientsa

    Patient Group (n = 24)Control Group (n = 21)
    Male/female7/1712/9
    Mean age (yr) (SD)58.45 (8.73)55.17 (9.70)
    GCS (SD)13.74 (1.42)
    Ruptured artery (AcomA, IC-PcomA, MCA, other ICA, BA, PA)14, 3, 2, 2, 2, 1
    Fisher CT grade (SD)2.75 (0.44)
    Duration from onset (week) (SD)6.49 (2.63)
    • Note:—AcomA indicates anterior communicating artery; IC-PcomA, internal carotid–posterior communicating artery; BA, basilar artery; PA, pericallosal artery.

    • ↵a Values represent mean (SD).

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    Table 2:

    Mean values for diffusion tensor imaging parameters and correlations between Glasgow Coma Scale score and diffusion tensor imaging parameters of the ascending reticular activating systema

    Patient GroupControl Group
    More Affected SideLess Affected SideBoth Sides
    FA0.40 ± 0.10 (0.150)0.42 ± 0.03 (−0.238)0.41 ± 0.05 (0.073)0.41 ± 0.03
    ADC0.93 ± 0.09 (−0.079)0.93 ± 0.08 (−0.003)0.93 ± 0.07 (−0.052)0.95 ± 0.12
    TN352 ± 94 (0.890b)441 ± 71 (0.798b)396.45 ± 76.04 (0.919b)459.13 ± 54.91
    • Note:—TN indicates tract number.

    • ↵a Values represent mean ± SD (correlation coefficient) and mean average values for both sides between the right and left hemispheres.

    • ↵b Significant differences (P < .05).

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American Journal of Neuroradiology: 36 (4)
American Journal of Neuroradiology
Vol. 36, Issue 4
1 Apr 2015
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S.H. Jang, H.S. Kim
Aneurysmal Subarachnoid Hemorrhage Causes Injury of the Ascending Reticular Activating System: Relation to Consciousness
American Journal of Neuroradiology Apr 2015, 36 (4) 667-671; DOI: 10.3174/ajnr.A4203

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Aneurysmal Subarachnoid Hemorrhage Causes Injury of the Ascending Reticular Activating System: Relation to Consciousness
S.H. Jang, H.S. Kim
American Journal of Neuroradiology Apr 2015, 36 (4) 667-671; DOI: 10.3174/ajnr.A4203
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