Coma and Brain Death

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Purpose of Review: This article discusses the diagnostic and therapeutic approach to patients who are comatose and reviews the current knowledge on prognosis from various causes of coma. This article also provides an overview of the principles for determination of brain death as well as advice on how to avoid common pitfalls. Recent Findings: Technologic advances have refined our understanding of the physiology of consciousness and the spectrum of disorders of consciousness; they also promise to improve our prognostic accuracy. Yet the clinical principles for the evaluation and treatment of coma remain unaltered. The clinical standards for determination of death by neurologic criteria (ie, brain death) are also well established, although variabilities in local protocols and legal requirements remain a problem to be resolved. Summary: Effective evaluation of coma demands a systematic approach relying on clinical information to ensure rational use of laboratory and imaging tests. When the cause of coma is deemed irreversible in the setting of a catastrophic brain injury and no clinical evidence exists for brain and brainstem function, patients should be evaluated for the possibility of brain death by following the clinical criteria specified in the American Academy of Neurology guidelines.

Original languageEnglish (US)
Pages (from-to)1708-1731
Number of pages24
JournalCONTINUUM Lifelong Learning in Neurology
Volume24
Issue number6
DOIs
StatePublished - Dec 1 2018

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Brain Death
Coma
Consciousness Disorders
Consciousness
Brain Injuries
Nervous System
Brain Stem
Guidelines
Brain
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

Cite this

Coma and Brain Death. / Rabinstein, Alejandro.

In: CONTINUUM Lifelong Learning in Neurology, Vol. 24, No. 6, 01.12.2018, p. 1708-1731.

Research output: Contribution to journalReview article

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