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Persistent vegetative state in head injury
oleh: Deepak Kumar Gupta, AK Mahapatra
Format: | Article |
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Diterbitkan: | Thieme Medical and Scientific Publishers Pvt. Ltd. 2005-12-01 |
Deskripsi
Vegetative state is a clinical condition of complete unawareness of the self and the environment, accompanied by sleep-wake cycles, with either complete or partial preservation of hypothalamic and brain-stem autonomic functions. The clinical course and outcome of a persistent vegetative state depend on its cause. Post-traumatic unawareness persisting for more than a month should not be considered an irreversible condition, because an outcome that might be regarded by some as being acceptable is possible even in patients with very severe brain damage. Recovery of consciousness from a posttraumatic persistent vegetative state is unlikely after 12 months in adults and children. For most such patients, life expectancy ranges from 2 to 5 years; survival beyond 10 years is unusual. Corpus callosum and dorsolateral brainstem lesions are highly significant in predicting non-recovery. Long-term prognosis of post-traumatic vegetative state (VS) remains poorly defined. Essential prognostic factors of VS include threat blink reflex presence, ventricular dilatation, brainstem and corpus callosal injury; motor score (Glasgow Coma Score) and presence of spontaneous eye movements.