To help understand where Chuck is in his level of his TBI (tramatic Brain Injury) I re-posted an old post From May13th. I also will included more information for you of the various levels of consciousness A Coma is a state like sleep, in which individuals are completely unarousable, will not open their eyes, and unresponsive to external stimulation and to their own inner needs. So called “true coma” of this nature generally persists for two weeks to a month after traumatic brain injury (TBI). A vegetative state is absence of responsiveness and awareness due to overwhelming dysfunction of the cerebral hemispheres. Patients may have complex reflexes, including eye movements, yawning, and involuntary movements to noxious stimuli, but show no awareness of self or environment. A minimally conscious state, unlike a vegetative state, is characterized by some evidence of awareness of self and/or the environment. . Symptoms and Signs Vegetative state: Patients show no evidence of awareness of self or environment and cannot interact with other people. Purposeful responses to external stimuli are absent, as are language comprehension and expression. Signs of an intact reticular formation (eg, eye opening) and an intact brain stem (eg, reactive pupils, oculocephalic reflex) are present. Sleep-wake cycles occur but do not necessarily reflect a specific circadian rhythm and are not associated with the environment. More complex brain stem reflexes, including yawning, chewing, swallowing, and, uncommonly, guttural vocalizations, are also present. Arousal and startle reflexes may be preserved; eg, loud sounds or blinking with bright lights may elicit eye opening. Eyes may water and produce tears. Patients may appear to smile or frown. Spontaneous roving eye movements—usually slow, of constant velocity, and without saccadic jerks—may be misinterpreted as volitional tracking and can be misinterpreted by family members as evidence of awareness. Patients cannot react to visual threat and cannot follow commands. The limbs may move, but the only purposeful motor responses that occur are primitive (eg, grasping an object that contacts the hand). Pain usually elicits a motor response (typically decorticate or decerebrate posturing) but no purposeful avoidance. Minimally conscious state: Fragments of meaningful interaction with the environment are preserved. Patients may establish eye contact, purposefully grasp at objects, respond to commands in a stereotypic manner, but not always consistently. There are other states to follow, but at this point we believe that Chuck is passed the vegetative state and now is in a Minimal Conscious state.
Posted on: Fri, 01 Aug 2014 02:27:01 +0000
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