Brain scans reveal that some people who can’t speak or move are aware of the world around them
A medical team surrounded Maria Mazurkevich’s hospital bed, all eyes on her as she did … nothing. Mazurkevich was 30 years old and had been admitted to New York–Presbyterian Hospital at Columbia University on a blisteringly hot July day in New York City. A few days earlier, at home, she had suddenly fallen unconscious. She had suffered a ruptured blood vessel in her brain, and the bleeding area was putting tremendous pressure on critical brain regions.
The standard definition of a comatose patient is someone who is unconscious, is unable to be awakened, and has no signs of awareness or the ability to interact with the environment. Patients in a coma caused by severe brain injury may look indistinguishable from someone in a deep sleep, except that most comatose patients cannot breathe on their own and need support from a ventilator, with a tube inserted into their airway.
Detecting and predicting recovery of consciousness early on, in the intensive care unit, is often a matter of life or death. Families typically make decisions about continuing or stopping life-sustaining therapy within 10 to 14 days of the injury—the time when surgical procedures become necessary to support longer-term breathing and feeding.
Covert consciousness was subsequently identified in patients around the world, with varying types of brain injuries. In 2017 it was detected in seemingly unaware patients who had just been admitted to the intensive care unit at Massachusetts General Hospital with severe brain injuries, indicating that the covert phenomenon can occur in people who had very recently been hurt,, not only after patients have been “out” for weeks.
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