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NEUROLOGY 1986;36:178
© 1986 American Academy of Neurology

Consciousness and amnesia after penetrating head injury

Neurology and anatomy

Andres M. Salazar, MD, Jordan H. Grafman, PhD, Stephen C. Vance, MD, Herb Weingartner, PhD, J. D. Dillon, MD and Christy Ludlow, PhD

Vietnam Head Injury Study. Department of Clinical Investigation, Walter Reed Army Medical Center (Drs. Salazar, Grafman, Vance, and Dillon). Washington, DC; the Laboratory of Psychology & Psychopathology. Unit on Cognition. NIMH (Dr. Weingartner). Bethesda, MD. and the Medical Neurology Branch. Intramural Research Program. NINCDS (Dr. Ludlow). Bethesda, MD.

Among 342 men who survived severe penetrating brain wounds, only 15% had prolonged unconsciousness and 53% had no or momentary unconsciousness after injury, emphasizing the focal nature of these wounds. The left (or language-dominant) hemisphere was dominant for the "wakefulness" component of consciousness. The areas most associated with unconsciousness included the posterior limb of the left internal capsule, left basal forebrain, midbrain, and hypothalamus. Left dominance was not seen for posttraumatic amnesia after elimination of the wakefulness variable, suggesting that wakefulness may be linked to the role of the left hemisphere in verbal memory.

Address correspondence and reprint requests to Dr. Salazar, Vietnam Head Injury Study, Department of Clinical Investigation, Walter Reed Army Medical Center, Washington, DC 20307–5001.

This study is under Veterans Administration Contract #IGA V101 (91) M-79031–2 with the cooperation and support of the US Army. Navy, and Air Force, and the American Red Cross.

Accepted for publication June 14, 1985.




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