Re: Disconnection of the Ascending Arousal System in Traumatic Coma. J Neuropathol Exp Neurol 2013;72:505–523

In the June issue, Edlow et al used a cutting edge imaging tool to demonstrate tracts in the autopsied brain of a victim of traumatic coma (1). Histologic study of the same brain showed widespread axonal damage in keeping with the long-standing understanding that closed head injury results in diffuse axonal injury throughout the brain (2). The imaging analysis showed however, that only 1 set of pathways, that is, the “arousal” pathways connecting brainstem nuclei to the basal forebrain and to thalamic intmkminar and reticular nuclei, was completely disrupted. They proposed that traumatic coma is specifically related to this disconnection …