Vegetative state after closed-head injury. A Traumatic Coma Data Bank Report
H. S. Levin, C. Saydjari, H. M. Eisenberg, M. Foulkes, L. F. Marshall, R. M. Ruff, J. A. Jane and A. Marmarou
Division of Neurosurgery, University of Texas Medical Branch, Galveston 77550.
To elucidate the clinical course of the vegetative state after severe
closed-head injury, the Traumatic Coma Data Bank was analyzed for outcome
at the time of discharge from the hospital and after follow-up intervals
ranging up to 3 years after injury. Of 650 patients with closed-head injury
available for analysis, 93 (14%) were discharged in a vegetative state. In
comparison with conscious survivors, patients in a vegetative state
sustained more severe closed-head injury as reflected by the Glasgow Coma
Scale scores and pupillary findings and more frequently had diffuse injury
complicated by swelling or shift in midline structures. Of 84 patients in a
vegetative state who provided follow-up data, 41% became conscious by 6
months, 52% regained consciousness by 1 year, and 58% recovered
consciousness within the 3-year follow-up interval. A logistic regression
failed to identify predictors of recovery from the vegetative state.
