Date/Time: Monday, October 18, 2021 - 11:15 AM – 12:45 PM
Track: Interactive Workshop
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Description:

Disordered consciousness is commonly encountered by neurologists in patients with acute brain injuries. However, much uncertainty remains regarding recovery potential and trajectory and this frequently leads to inaccuracy and even mistakes in decisions regarding acute and long-term care. Neurologists are frequently called upon to prognosticate on outcome in patients with acute coma and impaired consciousness. However, many studies have now highlighted the concern of the self-fulfilling prophecy of poor outcome in patients that have the potential to recover but are not treated aggressively due to a presumed poor prognosis. Furthermore, recent studies involving advanced electrophysiology and neuroimaging have identified seemingly unresponsive patients with willful brain activity, a condition known as cognitive motor dissociation. Common themes likely exist regarding coma across conditions generally viewed as disparate such as traumatic brain injury, severe stroke, and central nervous system infections. New insights are advancing the science of consciousness in adults and children and this may lead to improved targets for intervention and better clinical decision-making.

Co-Chair: Romer Geocadin, MD

Co-Chair: J. Claude Hemphill III, MD, MAS

Objective(s):

• Describe how covert consciousness may be detected

• Discuss how to acknowledge uncertainty in prognostication

• Develop a standardized brain death protocol at the provider's institution