The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.

Caring for a loved one in a coma is a distressing time, full of many questions, and often, not as many answers. Guide to a Comatose Patient is a first-of-its-kind book that steps into the shoes of the neurologist, to show the perspective of the staff caring for their loved ones — what worries us, how we think and intervene, what we can and cannot predict, and what we know as a certainty. In our hospital ICUs, there are more than a dozen comatose patients at any given point of time. Causes of coma can range from drug-induced coma—in which medications are used to calm the patient and allow the ventilator to work properly—to coma due to intoxication and coma related to a brain injury. No matter the reason, it can be a distressing time for loved ones. Guide to a Comatose Patient is a helpful guide for any family member or loved one confronted with coma. Author Eelco F. M. Wijdicks, M.D., Ph.D., a leading neurologist and attending neurointensivist at Mayo Clinic, begins each chapter by sharing helpful anecdotes from a career spanning four decades, before diving into the answers to commonly asked questions, such as: · What are the causes of coma? · When will the patient wake up and recover? · When is no recovery expected? · When should we consider organ donation? · What are the rates of survival? While there are many books on families’ experiences with acute traumatic brain injury and coma, Dr. Wijdicks offers an unusually candid conversation that allows a peek inside the minds of the doctors caring for your loved one. Having had many experiences talking to families having to make difficult decisions at a very difficult time, Dr. Wijdicks’s message is hopeful while remaining grounded in reality—a reality in which facts must dictate actions. Guide to a Comatose Patient provides important information so that families better understand treatment options, but most importantly, the book offers an open dialogue and optimal transparency to help provide hope and healing through times of grief.

Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.

Clifford B. Saper, Chair of Neurology at Harvard Medical School, and Nicholas D. Schiff of Weill Medical College in NY join the original authors to thoroughly update this seminal text with over 90% new material. the goal of the new edition is to provide a clinically slanted volume that will help the reader understand and diagnose severe brain dysfunction both as it exists and as it evolves in the seriously ill. the book remains a treatise on pathophysiology because recent imaging, electrophysiologic, and biochemical technologies (discussed in the book) are by themselves insufficient substitute

Caring for a loved one in a coma is a distressing time, full of many questions, and often, not as many answers. Guide to a Comatose Patient is a first-of-its-kind book that steps into the shoes of the neurologist, to show the perspective of the staff caring for their loved ones — what worries us, how we think and intervene, what we can and cannot predict, and what we know as a certainty. In our hospital ICUs, there are more than a dozen comatose patients at any given point of time. Causes of coma can range from drug-induced coma—in which medications are used to calm the patient and allow the ventilator to work properly—to coma due to intoxication and coma related to a brain injury. No matter the reason, it can be a distressing time for loved ones. Guide to a Comatose Patient is a helpful guide for any family member or loved one confronted with coma. Author Eelco F. M. Wijdicks, M.D., Ph.D., a leading neurologist and attending neurointensivist at Mayo Clinic, begins each chapter by sharing helpful anecdotes from a career spanning four decades, before diving into the answers to commonly asked questions, such as: · What are the causes of coma? · When will the patient wake up and recover? · When is no recovery expected? · When should we consider organ donation? · What are the rates of survival? While there are many books on families’ experiences with acute traumatic brain injury and coma, Dr. Wijdicks offers an unusually candid conversation that allows a peek inside the minds of the doctors caring for your loved one. Having had many experiences talking to families having to make difficult decisions at a very difficult time, Dr. Wijdicks’s message is hopeful while remaining grounded in reality—a reality in which facts must dictate actions. Guide to a Comatose Patient provides important information so that families better understand treatment options, but most importantly, the book offers an open dialogue and optimal transparency to help provide hope and healing through times of grief.

When Carl awakens from a coma after being attacked on a subway train, life around him feels unfamiliar, even strange. He arrives at his best friend's house without remembering how he got there; he seems to be having an affair with his secretary, which is pleasant but surprising. He starts to notice distortions in his experience, strange leaps in his perception of time. Is he truly reacting with the outside world, he wonders, or might he be terribly mistaken? So begins a dark psychological drama that raises questions about the the human psyche, dream versus reality, and the boundaries of consciousness. As Carl grapples with his predicament, Alex Garland - author of The Beach and the screenplay for 28 Days Later, plays with conventions and questions our assumptions about the way we exist in the world, even as it draws us into the unsettling and haunting book about a lost suitcase and a forgotten identity.

This revised and expanded second edition discusses the assessment and treatment of patients recovering from coma and disorders of consciousness. Besides diagnostic, prognostic and ethical issues, this book describes well-established techniques and procedures, and also techniques under development. New chapters include consciousness theories, issues relating to long-term care, and neuromodulation treatments. Coma and Disorders of Consciousness, Second Edition is a comprehensive review of the field for clinicians and researchers, regardless of whether they are already familiar with the difficult but exciting field of disorders of consciousness.