For professionals

Introduction

People who do not return to consciousness after acute brain injury may have problems related to the interpretation of their condition. This is the case, for example, when considering whether to stop artificially administering fluids and nutrition to patients in a prolonged vegetative state, from which recovery is no longer possible. Sometimes there is discussion about whether or not there is consciousness, for example if changes in the clinical picture occur even after years. Previously, this journal described the importance of an adequate diagnosis before making drastic decisions.

In particular, it is difficult to distinguish between 'no signs of consciousness' and 'minimal signs of consciousness' (also known as a low-conscious state). Developing an expertise in making that distinction is only possible for a few, as the prevalence of the long-term vegetative state is low: in 2003, only 32 such patients were known in Dutch nursing homes.