author={G. Bryan Young},
  journal={Annals of the New York Academy of Sciences},
  • G. B. Young
  • Published 1 March 2009
  • Medicine, Psychology
  • Annals of the New York Academy of Sciences
Coma is a state of unarousable unconsciousness due to dysfunction of the brain's ascending reticular activating system (ARAS), which is responsible for arousal and the maintenance of wakefulness. Anatomically and physiologically the ARAS has a redundancy of pathways and neurotransmitters; this may explain why coma is usually transient (seldom lasting more than 3 weeks). Emergence from coma is succeeded by outcomes ranging from the vegetative state to complete recovery, depending on the severity… 

Neurophysiology and Treatment of Disorders of Consciousness Induced by Traumatic Brain Injury: Orexin Signaling as a Potential Therapeutic Target.

Several studies demonstrated that the agonists of orexin might be effective in the treatment of DOC, providing novel therapeutic opportunities in this field of TBI-induced DOC.

Posterior Reversible Encephalopathy in Sepsis-Associated Encephalopathy: Experience from a Single Center

Patients with Posterior reversible encephalopathy syndrome were selected from a consecutively enrolled cohort of 156 patients with SAE and assessed for neurological outcome using the extended Glasgow Outcome Scale for 12 months and showed increased prevalence of seizures and intraabdominal source of infection.

Applied potential of task-free event-related paradigms for assessing neurocognitive functions in disorders of consciousness

A novel approach is suggested that combines a set of well-tested auditory event-related potential components, recorded using EEG, to provide a multidimensional assessment of cognitive and linguistic processes, which may help physicians make a more precise diagnosis of patients with disorders of consciousness.

Unlocking the Voices of Patients with Severe Brain Injury

This paper critically examines whether patients with severe brain injury, who can only communicate through assistive neuroimaging technologies, may permissibly participate in medical decisions, and presents a modified approach to medical decision making.

A Novel INCNS Score for Prediction of Mortality and Functional Outcome of Comatose Patients

The INCNS score could be used for predicting the functional outcomes and mortality rate of comatose patients and had better predictive performance of 3-month mortality than APACHE II.

Toward a global and reproducible science for brain imaging in neurotrauma: the ENIGMA adult moderate/severe traumatic brain injury working group

The ENIGMA working group will offer investigators an unprecedented opportunity to test important hypotheses about recovery and morbidity in AMS-TBI by taking advantage of the robust methods for large-scale neuroimaging data analysis.

During COMA, Body Pathology of CT/MRI Changes: A Case Report with Literature Review

  • Medicine
    European Journal of Medical and Health Sciences
  • 2022
This study discovered that the body changes during cardiopulmonary arrest, and internal body pathology observation in detail and patient CT/MRI changes by the time the cardiopULmonary arrest happened.



Prognostic Value of Evoked Responses and Event-Related Brain Potentials in

It is concluded that objective prognostication is enhanced by the use of electrophysiological tests in comatose patients with coma of different etiologies and an approach that combines clinical and electrophysics values provides optimal prediction of outcome and level of disability.

Coma and Impaired Consciousness: A Clinical Perspective

Part 1 Consciousness, major syndromes and approach: consciousness - definition and context major syndromes of impaired consciousness clinical assessment, investigation and initial management. Part 2

Sleep, consciousness and the spontaneous and evoked electrical activity of the brain. Is there a cortical integrating mechanism?

  • B. Evans
  • Biology, Psychology
    Neurophysiologie Clinique/Clinical Neurophysiology
  • 2003

Simulation of Brain Death from Fulminant De-efferentation

A fulminant neuropathy can result in a clinical state resembling ìbrain deathî through diffuse de-efferentation, and a primary axonopathy can also lead to a similar clinical presentation.

Lateral displacement of the brain and level of consciousness in patients with an acute hemispheral mass.

  • A. Ropper
  • Medicine, Psychology
    The New England journal of medicine
  • 1986
Brain-tissue shifts associated with drowsiness, stupor, and coma were studied by clinical examination and CT scanning in 24 patients with acute unilateral cerebral masses and Contrary to traditional concepts, early depression of the level of alertness corresponded to distortion of the brain by horizontal displacement rather than transtentorial herniation with brain-stem compression.

Selective abolition of the vestibular-ocular reflex by sedative drugs

Sedatives may selectively and transiently abolish the vestibulo-ocular reflex, altering the clinical examination; this is to be considered in the examination of a patient with coma.

Multimodality evoked potentials and early prognosis in comatose patients

In 112 comatose patients somatosensory, visual and auditory evoked potentials were registered within 36 hours after the onset of coma or admission and it was concluded that SEPs can be valuable for the prognosis of coma after primary brain lesions.

The significance of myoclonic status epilepticus in postanoxic coma

It is concluded that in patients with bilaterally synchronous facial myoclonus, bilateral loss of pupillary or oculovestibular reflexes, and suppression and burst-suppression on EEG, it is not warranted to use anesthetic barbiturates to treat MSE.

Current reporting of responsiveness in acute cerebral disorders. A survey of the neurosurgical literature.

One hundred sixty-six papers published in seven neurosurgical journals from 1983 through 1985 have been surveyed to determine the methods used for assessment of overall patient responsiveness in

Sepsis-associated encephalopathy: Evolving concepts

The encephalopathy in the acute phase clinically resembles many metabolic encephalopathies: a diffuse disturbance in cerebral function with sparing of the brain stem.