Persistent vegetative state: Ventricular csf pulsation artifact

One of the major limitations of FLAIR imaging is the ventricular CSF pulsation artifact (VCSFA). This artifact could compromise the study of ventricular abnormalities by leading to false-negative or false-positive interpretations. We report 4 young persistent vegetative state (PVS) patients with severe ventriculomegaly and brain atrophy who showed VCSFA on FLAIR MR imaging. FLAIR axial images showed the presence of a hyperintensity. occupying the fourth, third, lateral ventricles, and the aqueduct of Sylvius. VCSFA was more prominent in the third and fourth ventricles, compared with the lateral ventricles. In PVS, both severe ventriculomegaly and brain atrophy might induce nonappropriate CSF circulation nulling, which remains hyperintense on axial FLAIR images, leading to VCSFA coming out. This is the first report in literature about the presence of VCSFA in PVS patients.