Disorders of consciousness secondary to traumatic brain injuries: essential concepts

Abstract

People with severe traumatic brain injury can experience disorders of consciousness. In this paper the most common are described: Coma, Unresponsive Wakefulness Syndrome, Minimally Conscious State and Posttraumatic Confusional State. Coma is a disorder of consciousness characterized by the total absence of responses. The Unresponsive Wakefulness Syndrome involves the absence of awareness of oneself and the environment, with the presence of sleep-wake cycles. While in the Minimally Conscious State is observed minimal behavioral evidence suggesting self-awareness. Finally, the Posttraumatic Confusional State has as its distinctive features disorientation (in person, space, and time), attentional disorder and memory impairment. Although this taxonomy is extremely useful, the clinical-care reality demands new approaches that understand consciousness from a perspective that combines diagnostic and rehabilitative interests.