To the Editor.
—From a group of 81 patients in coma, Dr Hansotia1 reported the clinical and electrophysiologic findings in eight who manifested the "persistent vegetative state." All eight patients sustained nontraumatic brain injuries, and none improved beyond the vegetative state, including four who died.Caution may be necessary in extrapolating from these data to victims of traumatic brain injury, who tend to be younger2 than the mean age of 60 years in Dr Hansotia's1 study group. Increasing age in patients with head trauma is associated with greater mortality,3 and we might therefore expect increased age to contribute to a poorer prognosis in nontraumatic brain injury as well. Two reported cases of meaningful recovery from nontraumatically induced vegetative states were in relatively younger (ages 434 and 235 years) individuals.The pathophysiology of the vegetative state may differ when the injury is less global than
Musto RV. Persistent Vegetative State and Head Trauma. Arch Neurol. 1986;43(5):431–432. doi:10.1001/archneur.1986.00520050011008
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