author={G. Bryan Young},
  journal={Annals of the New York Academy of Sciences},
  • G. B. Young
  • Published 1 March 2009
  • Medicine
  • 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… Expand
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. Expand
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. Expand
The effect of family-centered sensory and affective stimulation on comatose patients with traumatic brain injury: A systematic review and meta-analysis.
Early family-centered sensory and affective stimulation is more effective than routine care and nurse-implemented sensory stimulation in improving the level of consciousness and cognition of comatose patients with traumatic brain injury, and multi-sensory stimulation isMore effective than single stimulation. Expand
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. Expand
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. Expand


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. Expand
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 2Expand
Sleep, consciousness and the spontaneous and evoked electrical activity of the brain. Is there a cortical integrating mechanism?
  • B. Evans
  • Psychology, Medicine
  • Neurophysiologie Clinique/Clinical Neurophysiology
  • 2003
Anatomical and physiological studies suggest that there may be a double thalamo-cortical network; one relating to cortical and thalamic areas with specific functions and the other global, involving all cortical areas and so-called 'non-specific' thalamate nuclei, responsible for much of the spontaneous and evoked electrical activity of the brain. Expand
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. Expand
Lateral displacement of the brain and level of consciousness in patients with an acute hemispheral mass.
  • A. Ropper
  • Medicine
  • 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. Expand
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. Expand
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. Expand
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. Expand
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 inExpand
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. Expand