Table 6.
Relationship between symptoms/signs and pathological MRI changes
| Symptoms/signs | Negative results, but with symptoms (n) | Fatal cases (n) | Total cases with symptoms (n) | na | Nerve activity may be involved | Neuron/cerebral nuclei | Lesion localization in MRI |
|---|---|---|---|---|---|---|---|
| Startled | 23 | 4 | 211 | 20 | Startle Reflex | Anterior horn motor neurons | Amygdala |
| (Short-pathway) Motor nerve fibers; anterior horn of the spinal cord; amygdala, caudate nucleus; thalamus | Amygdala | Caudate nucleus | |||||
| (Long pathway) Short-pathway and frontal cortex | Caudate nucleus; thalamus | Thalamus | |||||
| Limbic system | Cortex | ||||||
| Frontal Cortex | |||||||
| Myoclonic jerks/tremors | 26 | 1 | 162 | 20 | Extrapyramidal System & Pyramidal System | Olive-Red Nucleus-Dentate Nucleus; | Olive nucleus |
| Red Nucleus | Basal ganglia | ||||||
| Motor nerve fibers in head, face and neck | Basal Ganglia | Dentate nucleus | |||||
| Rubrospinal tract | Cranial nerve nuclei | Spinal | |||||
| Brainstem spinal tract | Spinal motor neurons | Spinal nerve roots | |||||
| Extrapyramidal tract | Spinal nerve roots | ||||||
| Pyramidal tract | |||||||
| Fatigue/sleepiness | 25 | 7 | 115 | 19 | Tonic stretch reflex | Spinal cord | Spinal cord |
| Muscle tension | Brainstem | Brainstem | |||||
| Basal ganglia | Basal ganglia | ||||||
| Cortex | Cortex | ||||||
| Cerebellum | |||||||
| Vomiting | 11 | 4 | 74 | 11 | Vomiting reflex | Olive nucleus | Olive nucleus |
| Vagus; sympathetic | Spinal motor neurons | Spinal motor neurons | |||||
| Phrenic nerve | |||||||
| Spinal nerve | |||||||
| Anxiety | 3 | 3 | 39 | 8 | Defensive reflex | Striaterminalis | Basal ganglia |
| Motor nerve fibers in head, face and neck | amygdala; hypothalamus | Thalamus | |||||
| Midbrain | |||||||
| Limbic system | |||||||
| CRT extension | 2 | 7 | 27 | 7 | Vascular autonomic regulation | Brainstem | Brainstem |
| Sympathetic (α) | Spinal cord | Spinal cord | |||||
| Sympathetic trunk | |||||||
| Somnolence | 4 | 5 | 25 | 7 | Sleep-awareness cycle | Midbrain | Brainstem |
| Pons | Midbrain | ||||||
| Coeruleus | Pons | ||||||
| Medullary reticular formation | |||||||
| Abnormal respiratory rhythm | 2 | 7 | 19 | 7 | Anterior horn motor nerve fibers | Pons | Pons |
| Pulmonary edema and/or hemorrhage | 7 | 7 | 23 | 7 | Sympathetic-mediated | Brainstem | Brainstem |
| Spinal cord | Thoracic spinal cord Spinal nerve roots | ||||||
| Sympathetic trunk | |||||||
| Tachycardia | 4 | 2 | 12 | 6 | Cardiovascular autonomic regulation | Brainstem | Brainstem |
| Sympathetic | Spinal cord | Spinal cord | |||||
| Vagus nerve | Sympathetic trunk | ||||||
| Nystagmus | 0 | 2 | 16 | 5 | Cranial nerve III, IV, VI | Cranial nerve nuclei III, IV, VI | Midbrain |
| Pons | |||||||
| Eyeball ataxia | 1 | 4 | 10 | 4 | Cranial nerve III, IV, VI | Cranial nerve nuclei III, IV, VI | Midbrain |
| Pons | |||||||
| Hyperventilation | 1 | 7 | 8 | 4 | Anterior horn motor nerve fibers | Midbrain | Midbrain |
| Flaccid paralysis | 0 | 1 | 12 | 4 | Motor nerve fibers | Anterior horn motor neurons | Spinal cord |
| Spinal nerve roots | Spinal cord | Spinal nerve roots | |||||
| Anterior horn of the spinal cord | |||||||
| Fright | 3 | 2 | 14 | 3 | Defensive reflex | Amygdala; Hypothalamus | Hypothalamus |
| (Short-pathway) Anterior horn motor nerve fibers; amygdala; Caudate nucleus; thalamus | Dorsal central midbrain | Midbrain | |||||
| (Long pathway) Short path and cortex | Limbic system | ||||||
| Absent pharyngeal reflex | 1 | 4 | 8 | 3 | Pharyngeal reflex | Cranial nerve nuclei V, IX, X, XII | Midbrain |
| Trigeminal; vagus | Pons | ||||||
| Glossopharyngeal | Medulla oblongata | ||||||
| Hypoglossal |
aTotal number with pathological changes was 29 patients among the 77 survivors who underwent head and spinal cord MRI examination