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A vegetative state (VS) or post-coma unresponsiveness (PCU) [1] is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state, the patient is classified as being in a persistent vegetative state (PVS).
In 1994, this South African switchboard operator fell into a persistent vegetative state after being hit by a truck while riding his bike. In 1999, Dr. Wally Nel gave him Zolpidem (also known as Ambien) after a nurse told Viljoen's mother that involuntary spasms in his left arm had caused him to tear his mattress and that this could have been ...
Time is the best general predictor of a chance of recovery. For example, after four months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low. [50] The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage.
After brain death the patient lacks any sense of awareness; sleep-wake cycles or behavior, and typically look as if they are dead or are in a deep sleep-state or coma. Although visually similar to a comatose state such as persistent vegetative state, the two should not be confused. Criteria for brain death differ from country to country.
Coma and persistent vegetative state may result from cardiac arrest. Cardiac arrest is also identified by a lack of central pulses and abnormal or absent breathing. [1] Cardiac arrest and resultant hemodynamic collapse often occur due to arrhythmias (irregular heart rhythms).
Level of consciousness can be lowered when the brain receives insufficient oxygen (as occurs in hypoxia); insufficient blood (as occurs in shock, in children for example due to intussusception); or has an alteration in the brain's chemistry. [3] Conditions of the heart and conditions of the lungs can alter consciousness.
The Glasgow Outcome Scale (GOS) is an ordinal scale used to assess functional outcomes of patients following brain injury. It considers several factors, including a patient's level of consciousness, ability to carry out activities of daily living (ADLs), and ability to return to work or school.
The vegetative state is considered permanent if it persists for 12 months after TBI or 3 months after causes other than trauma. [ 6 ] A minimally conscious state is a condition in which patients have a reduced level of arousal and may appear, on the surface, to be in a persistent vegetative state but are capable of demonstrating the ability to ...