Abstract
ABSTRACT Evaluation of coma in the intensive care unit can be a very common and complicated consultation for the neurologist. Unlike other consultations, the neurologist often is asked to counsel the family in addition to providing an opinion on the prognosis of the patient. As an aid to this difficult challenge, this chapter will discuss the definition of coma, two approaches to the evaluation of coma, and strategies to determine the prognosis of a patient with coma. In addition, the chapter will discuss recent research in the nature of the vegetative state, which is one of the major outcomes of coma. Ultimately, the decisions that are made by families with their physicians about withdrawing or continuing life-preserving care for patients rest in the understanding of the likely prognosis of the patient. Well-informed discussions are becoming increasingly difficult as our understanding of cognitive function in coma and vegetative state evolves.
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