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New EAN Guideline on the diagnosis of coma and other disorders of consciousness
The level of consciousness in patients with severe brain injury can be difficult to assess. The problem is that clinical evaluation often is unreliable – consciousness may wax and wane, requiring sufficient arousal which is often not achieved; and even when it is, patients may still be awake and aware but unable to show it due to motor paralysis or language deficits. This is true for the acute setting in intensive care and with chronic brain injury, e.g. in neurorehabilitation or nursing homes. The question is: How many unresponsive patients with acute brain injury have preserved consciousness or may have the potential for it? The answer is important for prognosis, treatment and resource allocation.
