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June 1991

Vegetative State After Closed-Head Injury: A Traumatic Coma Data Bank Report

Author Affiliations

From the Division of Neurosurgery, the University of Texas Medical Branch, Galveston (Drs Levin and Eisenberg and Ms Saydjari); Office of Biometry, National Institutes of Health, Bethesda, Md (Dr Foulkes); Division of Neurosurgery, University of California at San Diego (Drs Marshall and Ruff); Department of Neurosurgery, University of Virginia, Charlottesville (Dr Jane); and Department of Neurosurgery, Medical College of Virginia, Richmond (Dr Marmarou).

Arch Neurol. 1991;48(6):580-585. doi:10.1001/archneur.1991.00530180032013

• To elucidate the clinical course of the vegetative state after severe closed-head injury, the Traumatic Coma Data Bank was analyzed for outcome at the time of discharge from the hospital and after follow-up intervals ranging up to 3 years after injury. Of 650 patients with closed-head injury available analysis, 93(14%) were discharged in a vegetative state. In comparison with conscious survivors, patients in a vegetative state sustained more severe closed-head injury as reflected by the Glasgow Coma Scale scores and pupillary findings and more frequently had diffuse injury complicated by swelling or shift in midline structures. Of 84 patients in a vegetative state who provided follow-up data, 41% became conscious by 6 months, 52% regained consciousness by 1 year, and 58% recovered consciousness within the 3-year follow-up interval. A logistic regression failed to identify predictors of recovery from the vegetative state.

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