Partial recovery of vegetative state after a massive ischaemic stroke in a child with sickle cell anaemia

Calixto MacHado, Rafael Rodríguez-Rojas, Gerry Leisman

Research output: Contribution to journalArticlepeer-review


A 15-year-old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye opening and spastic quadriparesis with no evidence of command-following, gestural or verbal communication, visual pursuit or purposeful motor behaviour. Our case was in an 'unresponsive wakefulness syndrome' with atrophy of lateral and frontal regions of both hemispheres, demonstrated by MRI and preservation of circulation in the posterior arterial system, documented by MR angiography. Currently observed are spontaneous eye opening, preserved visual and auditory startle reflexes, normal brainstem reflexes, and grasp, palmomental and sucking reflexes. Our case demonstrates partial recovery of awareness with significant brain lesions, reflecting preserved brain activity as an indication of the modular nature of functional networks.

Original languageEnglish
Article numbere233737
JournalBMJ Case Reports
Issue number5
StatePublished - 5 May 2020

Bibliographical note

Publisher Copyright:
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.


  • clinical neurophysiology
  • neuroimaging
  • neurological injury
  • rehabilitation medicine
  • stroke
  • Anemia, Sickle Cell/complications
  • Consciousness
  • Humans
  • Recovery of Function
  • Ischemic Stroke/diagnostic imaging
  • Persistent Vegetative State/diagnostic imaging
  • Wakefulness
  • Adolescent

ASJC Scopus subject areas

  • General Medicine


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