Accelerated emergence from a nontraumatic minimally conscious state with levodopa/carbidopa

Ernesto Bancalari, Alejandro Rabinstein, Francisco Machiavello, Alejandro Desmaison

Research output: Contribution to journalArticlepeer-review


A 62-year-old woman was admitted to our hospital in coma following the nontraumatic rupture of a left posterior inferior cerebellar artery aneurysm with subsequent intraventricular hemorrhage and acute hydrocephalus, affecting mainly the fourth ventricle with substantial adjacent edema (figure 1). Her Glasgow Coma Scale score was 3/15 and physical examination showed left hemiparesis, absent corneal and oculovestibular reflexes. Dexamethasone (4 mg q6h) and mannitol (1 g/kg initially, then 0.5 mg/kg q6h) were started, and a frontal bilateral trephination with external ventricular drainage was performed. Initial sedation was waned and discontinued 7 days later. The right and left ventricular drains were removed 9 and 15 days after placement, respectively, when a head CT scan showed reduction of the intraventricular hemorrhage and hydrocephalus (figure 2). Transcranial Doppler on days 2 and 8 showed no vasospasm. Serial EEGs on days 14, 21, and 28 showed no ictal activity. The aneurysm was successfully embolized 34 days after admission.

Original languageEnglish (US)
Pages (from-to)541-542
Number of pages2
JournalNeurology: Clinical Practice
Issue number6
StatePublished - Dec 1 2018

ASJC Scopus subject areas

  • Clinical Neurology


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