‘It’s Gigantic’: A New Way to Gauge the Chances for Unresponsive Patients

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(New York Times)- Doctors have known for years that some patients who become unresponsive after a severe brain injury nonetheless retain a “covert consciousness,” a degree of cognitive function that is important to recovery but is not detectable by standard bedside exams.

As a result, a profound uncertainty often haunts the wrenching decisions that families must make when an unresponsive loved one needs life support, an uncertainty that also amplifies national debates over how to determine when a patient in this condition can be declared beyond help.

Now, scientists report the first large-scale demonstration of an approach that can identify this hidden brain function right after injury, using specialized computer analysis of routine EEG recordings from the skull. The new study, published Wednesday in the New England Journal of Medicine, found that 15 percent of otherwise unresponsive patients in one intensive care unit had covert brain activity in the days after injury.

Moreover, these patients were nearly four times more likely to achieve partial independence over the next year with rehabilitation, compared to patients with no activity. CONTINUE