case_images: PMC9989168_01
case_images: The T2-Flair sequencing MR image of the periaqueductal region of the midbrain (A), mammillary bodies (B), thalamus (C), and parietal cortices (D) on postoperative day 13 (POD13) and the T2-Flair sequencing MR image of the periaqueductal region of the midbrain (E), mammillary bodies (F), thalamus (G), and parietal cortices (H) on POD 40.
case_images: fsurg-10-1016347-g001.jpg
case_images: PMC9989168_01_fsurg-10-1016347-g001.jpg
case_images: F1
case_images: To ascertain the reason for her state of unconsciousness, we performed a craniocerebral magnetic resonance imaging (MRI) on this patient, which revealed abnormal signals from the bilateral medial thalamus, third ventricle, posterior brainstem, and periaqueductal gray matter (Figure 1A). A craniocerebral MRI on POD 40 (Figure 1B) indicated a shrunken lesion in her brain, providing another reliable evidence on the effectiveness of thiamine therapy.
case_images: The variations in the blood lactate level (A) and platelet count (B).
case_images: fsurg-10-1016347-g002.jpg
case_images: PMC9989168_01_fsurg-10-1016347-g002.jpg
case_images: F2
case_images: The supplement of thiamine was reinforced (500 mg every 8 h) 3 days later (Figure 2A). Correspondingly, her blood lactate levels began to decline gradually when we enhanced thiamine supplementation (Figure 2A) and found her response to stitching improve. (2) We noticed that her platelet (PLT) count decreased acutely since POD 1 (53 x 109/L vs. 135 x 109/L before surgery), and this index kept dropping to 38 x 109/L on POD4, in spite of the multiple applications of rhIL-11 and platelet transfusion. Eventually, the blood PLT count increased to 149 x 109/L and remained stable (Figure 2B).