Coma and Disorders of Consciousness
This revised and expanded second edition discusses the assessment and treatment of patients recovering from coma and disorders of consciousness. Besides diagnostic, prognostic and ethical issues, this book describes well-established techniques and procedu
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Coma and Disorders of Consciousness
Caroline Schnakers • Steven Laureys Editors
Coma and Disorders of Consciousness Second Edition
Editors Caroline Schnakers Department of Research Casa Colina Hospital and Centers for Healthcare Pomona, CA USA
Steven Laureys GIGA Consciousness Coma Science Group & Neurology Department Liège Belgium
Department of Neurosurgery University of California Los Angeles, CA USA
University and University Hospital of Liège Liège Belgium
ISBN 978-3-319-55963-6 ISBN 978-3-319-55964-3 (eBook) DOI 10.1007/978-3-319-55964-3 Library of Congress Control Number: 2017946341 © Springer International Publishing AG 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
To medical teams and families we see every day and who inspire us.
Foreword I
Consciousness is synonymous with human existence. Rene Descartes’ bold proclamation, “Cogito ergo sum” (I think therefore I am), elegantly captures this premise. The clear inference here is that self-doubt about one’s own existence establishes proof of one’s existence. We exist because we know we exist. But how does one come to know that someone else is aware of his existence? Without direct access to knowledge of the self, it is impossible to prove (or disprove) the awareness of another. In normal consciousness, this problem is obviated by the multitude of behavioral expressions of conscious awareness manifested by living beings nearly every waking moment. Words, gestures, and actions, the “stuff” of consciousness, provide compelling evidence of the inner life of another. A small but significant percentage (5–10%) of those who sustain severe acquired brain injury expe
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