[Skip to Navigation]
Views 2,066
Citations 0
Editorial
March 1, 2021

Holding Out Hope After Traumatic Brain Injury

Author Affiliations
  • 1Division of Neurocritical Care, Department of Neurology, Yale School of Medicine, New Haven, Connecticut
JAMA Neurol. 2021;78(5):522-524. doi:10.1001/jamaneurol.2020.5328

Uncertainty of prognostication increases with more severe brain injury. Withdrawal of life-sustaining therapy (WLST) is often the proximate cause of death. Evidence suggests that level of consciousness may play a role in driving early WLST decisions.1 Studies have shown that many patients with traumatic brain injury (TBI) and other acute brain injuries regain consciousness within the first 72 hours, with most showing improvements in consciousness by 7 days after injury.2 However, the turning point at which a person who remains in a state of disordered consciousness will remain in this persistent state is still unclear. If no progress is seen in a patient’s arousal or awareness at 10 days or 2 weeks or 1 month, at what point do we consider pivoting our discussions about the likelihood of recovering consciousness?

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×