
Coma, Stupor, and Related Disorders of Consciousness
- 1st Edition, Volume 207 - February 26, 2025
- Imprint: Elsevier
- Editors: Peter W. Kaplan, Romergryko G. Geocadin
- Language: English
- Hardback ISBN:9 7 8 - 0 - 4 4 3 - 1 3 4 0 8 - 1
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 3 4 2 5 - 8
Coma, Stupor, and Related Disorders of Consciousness reviews recent research and best practice in the assessment and treatment of coma, stupor, and disorders of consci… Read more

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Request a sales quote- Reviews recent advances in disorders of consciousness
- Provides neural circuits and anatomy of DoC
- Identifies basis for differential diagnosis
- Summarizes best practices for therapy/intervention
- Includes imagery, EEG, evoked potentials of DoC
- Coma, Stupor, and Related Disorders of Consciousness
- Cover image
- Title page
- Table of Contents
- Series Page
- Copyright
- Handbook of Clinical Neurology 3rd Series
- Foreword
- Preface
- Contributors
- Chapter 1 Definitions, diagnostic criteria, and clinical assessment scales in disorders of consciousness
- Abstract
- Introduction
- Nomenclature, Nosology, and Diagnostic Criteria for Disorders of Consciousness
- Coma
- Unresponsive wakefulness state/vegetative state
- Minimally conscious state
- Emergence from minimally conscious state
- Confusional state
- Cognitive motor dissociation
- Clinical Assessment Scales
- Coma Recovery Scale–Revised
- Coma Recovery Scale–Revised For Accelerated Standardized Testing
- Simplified Evaluation of CONsciousness Disorders
- Full Outline of UnResponsiveness Score
- Western Neuro Sensory Stimulation Profile
- Wessex Head Injury Matrix
- Disorders of Consciousness Scale
- Sensory Modality Assessment and Rehabilitation Technique
- Revised Motor Behavior Tool
- Individualized Quantitative Behavioral Assessment
- The Curing Coma Campaign
- Conclusion
- References
- Chapter 2 A historical review of consciousness and its disorders
- Abstract
- Definition of Consciousness
- Concepts of Consciousness: Dualism vs Monism
- Monism predominates
- Further Contributions from Philosophy, Psychology, and Psychiatry
- Basic and Medical Science Contributions to Consciousness
- Disorders of Brain and Mental Functions
- Delirium
- Stupor and Coma
- Wakefulness With Variable Responsiveness and/or Awareness
- The Minimally Conscious State
- The Unresponsive Wakefulness Syndrome/Persistent Vegetative State
- Brain Death
- Remaining Challenges
- References
- Further reading
- Chapter 3 Neuroscience of coma
- Abstract
- Introduction
- Part 1: The Arousal System
- Brainstem
- Hypothalamus and basal forebrain
- White matter tracts
- Part 2: Regulation of Arousal Through the Central Thalamus and Mesocircuit
- The central thalamus
- Intralaminar nuclei
- The mesocircuit
- Part 3: The Awareness System
- Principles of the awareness system
- Where is the awareness system?
- How does awareness work?
- Regulation of the awareness system
- Part 4: Integrative Models of Consciousness
- Conclusions
- References
- Chapter 4 A scientific approach to diagnosis of disorders of consciousness
- Abstract
- Introduction
- Contemporary Taxonomy of DoC
- Coma
- Vegetative state/unresponsive wakefulness syndrome
- Minimally conscious state
- Emergence from minimally conscious state
- Locked-in syndrome
- Misdiagnosis and Misprognostication
- Behavioral Assessment
- Cognitive Motor Dissociation/Covert Consciousness
- Neuroimaging Diagnosis of DoC
- Stimulus-based fMRI
- Resting-state fMRI
- Electrophysiologic Diagnosis of DoC
- Conventional EEG
- Quantitative EEG
- Consensus Guidelines and Practical Recommendations
- Conclusion
- References
- Chapter 5 Cardiac arrest and disorders of consciousness
- Abstract
- Introduction
- Consciousness and Disorders of Consciousness
- Anatomy and Pathophysiology of Disorders of Consciousness
- Pathophysiology of Disorders of Consciousness after Cardiac Arrest
- Neurophysiologic Testing and Diagnostic Imaging
- Hospital course and management
- Neurologic Prognostication
- Future Directions
- References
- Chapter 6 Traumatic brain injury and disorders of consciousness
- Abstract
- Introduction
- Epidemiology and Definitions
- Neurobiology of Traumatic DOC
- Ascending reticular activating system
- Mesocircuit model
- Frontoparietal model
- Recovery
- Diagnostic Testing and Contributions to Prognostication
- Clinical exam
- Coma Recovery Scale—Revised
- Neuroimaging
- Structural imaging
- Diffuse axonal injury
- White matter injury and dysfunction
- Functional MRI
- Cognitive motor dissociation
- Positron emission tomography
- Electrophysiology
- Electrophysiology in the acute phase and risk of seizure
- Electrophysiology in the prolonged and chronic phases
- ABCD model
- Perturbational complexity index
- Evoked potentials
- Timeline for Recovery
- Predicting Emergence of Consciousness
- Prognostication in the acute phase
- Prognostication in the prolonged and chronic phases
- Clinical factors
- Therapeutic Opportunities
- Acute phase
- Prolonged and chronic phases
- Conclusions
- References
- Chapter 7 Advances in neuroimaging in disorders of consciousness
- Abstract
- Rationale
- Neuroimaging Tools: Basics
- CT, PET, and SPECT
- MRI
- Image Analysis
- Diagnosis of DoC Patients Aided With Neuroimaging
- CT, PET, and SPECT
- MRI
- Prognosis of DoC Patients Aided With Neuroimaging
- CT, PET, and SPECT
- MRI
- Future Perspectives and Open Questions
- Conclusion
- References
- Chapter 8 Electrophysiology in disorders of consciousness
- Abstract
- Introduction
- Shortcomings of Purely Behavioral Assessments of Consciousness
- Electroencephalography
- Electrode placement and artifact
- Conventional features
- Resting EEG in DoC
- Commonly encountered patterns
- Seizures and interictal continuum in DoC
- Prognostic patterns in DoC after cardiac arrest
- Brain death ancillary testing
- Sleep architecture
- Quantitative EEG
- Passive Stimulation
- Evoked potentials
- Event-related potentials
- Transcranial magnetic stimulation—EEG
- Active paradigms
- Detection of cognitive-motor dissociation in acute DoC using EEG
- Toward an Updated Taxonomy of DoC
- Integration of Electrophysiology Studies in Clinical Practice
- Challenges and Future Applications of EEG in DoC
- References
- Chapter 9 Evoked potentials in patients with disorders of consciousness
- Abstract
- Introduction
- General Principles of Evoked Potentials
- Evoked Potentials in Acute Disorders of Consciousness
- Short-Latency SSEPs After Cardiac Arrest
- Influence of filters, sedation, hypothermia, and timing of recordings on findings
- Bilaterally Absent Short-Latency SSEP (N20) in Patients After CA
- False-Positive Bilaterally Absent N20 After Cardiac Arrest
- Short-Latency SSEP Amplitudes (N20-P25) and Outcome Prediction After Cardiac Arrest
- Potential self-fulfilling prophecy
- High-Frequency Oscillations in Short-Latency SSEPs
- Short-Latency SSEPs and Outcome Prediction in Traumatic Brain Injury
- Middle-Latency SSEP—N70
- Short- and Middle-Latency AEP and Outcome Prediction in Acute DoC
- VEP and Outcome Prediction in Patients After Cardiac Arrest
- Long-Latency/Event-Related Potentials
- Mismatch Negativity in Patients With DoC
- P300/P3 (and Later ERPs) in Patients With DoC
- Guideline Recommendations on ERPs in Patients With Chronic DoC
- Conclusions
- References
- Chapter 10 Blood and cerebrospinal fluid biomarkers in disorders of consciousness
- Abstract
- Introduction
- Neuronal Biomarkers
- Neuron-specific enolase
- Neurofilament light chain
- Tau protein
- Ubiquitin C-terminal hydrolase L1
- α-II Spectrin
- Glial Biomarkers
- S100B
- Glial fibrillary acidic protein
- Inflammatory Biomarkers
- Metabolic Biomarkers
- Limitations and Recommendations for Future Biomarker Research
- References
- Chapter 11 Medical and surgical treatments in disorders of consciousness
- Abstract
- Introduction
- Medical Treatment Strategies for Disorders of Consciousness
- Dopaminergic drugs
- Gamma-aminobutyric acid (GABA)-agonistic drugs
- Surgical Treatment Strategies for Disorders of Consciousness
- Deep brain stimulation
- Vagal nerve stimulation
- Conclusions and Future Directions
- Conflicts of interest
- References
- Further reading
- Chapter 12 Non-pharmacologic interventions in disorders of consciousness
- Abstract
- Management Strategies to Promote Recovery After Coma: Where We Stand
- Introduction to disorders of consciousness and clinical management strategies
- Pathophysiologic models for severe brain injuries and recovery
- Brain stimulations therapies
- From Research to Practice_ Challenges for Translation to Clinical Setting
- Identify the optimal stimulation parameters and reveal their precise mechanisms of action
- Develop patient-fitted interventions based on endotype and phenotype
- Conclusions
- Conflict of interest statement
- References
- Chapter 13 Emerging ethical issues in patients with disorders of consciousness: A clinical guide
- Abstract
- Historical Context
- Ethical Issues in Diagnosis
- Ethical Issues in Prognosis
- The fallacy of the self-fulfilling prophecy
- Barriers to communication with surrogates
- Prognostic implications of identifying cognitive-motor dissociation
- Principles of Surrogate Decision-Making
- Shared decision-making
- Optimal Medical Care
- Refusal of Life-Sustaining Therapy
- Neuropalliative Care
- Human Rights and Systems of Care
- Future Directions
- References
- Chapter 14 Neurologic prognostication in coma and disorders of consciousness
- Abstract
- Introduction
- Coma and DoC
- Definitions
- Pathophysiology of DoC
- Neurologic Prognostication in DoC After Severe Acute Brain Injury
- Limitations of current prognostication practices
- Comatose survivors of cardiac arrest
- Prognostic markers in clinical practice
- DoC in acute ischemic stroke
- DoC in traumatic brain injury
- DoC in intracerebral hemorrhage
- DoC in aneurysmal subarachnoid hemorrhage
- Other DoC
- Future Perspectives
- Conclusion
- References
- Chapter 15 The Curing Coma Campaign: A platform for advancing science and clinical care worldwide
- Abstract
- Introduction
- Coma and Disorders of Consciousness: Where We Came From
- Beyond Clinical Assessment
- The Problem of Prognostication
- Coma as a Disease Entity
- A Blue Ocean for Neurocritical Care Research
- What Is the Curing Coma Campaign?
- Who Is the Curing Coma Campaign?
- Curing Coma Campaign Work to Date
- National Institutes of Health Symposia
- Gap analyses in coma science
- Ethics
- Initial CCC research studies
- World Coma Day
- The Worldwide Challenge of Curing Coma
- Scope
- Customs
- Resources
- Defining Success for Curing Coma
- Is this really a “moonshot”?
- The science of consciousness
- New treatments for coma and DoC
- Making coma care available and accessible
- Culture change in the care of patients with coma and DoC
- Future Directions
- References
- Index
- Edition: 1
- Volume: 207
- Published: February 26, 2025
- Imprint: Elsevier
- No. of pages: 325
- Language: English
- Hardback ISBN: 9780443134081
- eBook ISBN: 9780443134258
PK
Peter W. Kaplan
RG
Romergryko G. Geocadin
Dr. Romergryko G. Geocadin is a professor of neurology, neurosurgery, and anesthesiology-critical care medicine at the Johns Hopkins University School of Medicine in Baltimore, Maryland. He also currently serves as Co-Chair of the Johns Hopkins Clinician-Scientist Career Development Award Committee and is the Co-Founder/Co-Director of the Johns Hopkins Encephalitis Center. Dr. Geocadin completed his undergraduate education at the University of the Philippines-Diliman Campus, followed by his medical education at UERM School of Medicine in the Philippines, neurology residency at New York University, and neurocritical care clinical and research fellowship at Johns Hopkins University. He was founding Director of the Johns Hopkins Bayview Medical Center - Multidisciplinary Neurocritical Care Unit and past Chair of the Johns Hopkins Multidisciplinary Critical Care practice committee. Dr. Geocadin’s research, which focuses on translational studies on acute disorders of consciousness from animal models to clinical trials in brain injury after cardiac arrest resuscitation, is funded by the National Institutes of Health (NIH). He is one of the Principal Investigators for the ICECAP trial under the SIREN Network. Dr. Geocadin has led or contributed to the development of numerous practice guidelines, scientific statements, and reports from the American Academy of Neurology (AAN), American Heart Association, The Joint Commission, and the Institutes of Medicine on resuscitation and disorders of consciousness. Additionally. Dr. Geocadin was the Past President of the Neurocritical Care Society and the Vice President of the American Neurological Association from 2022 to 2024.