Post-traumatic apallic syndrome following head injury. Part 1: Clinical characteristics

Abstract

Epidemiological studies made within the western countries indicate an incidence of 200–300 traumatic head injuries per 100 000 residents each year. Severe head injuries account for 5–25% of all head injuries; 10–14% of all severe head-injured patients develop into a vegetative state, in which a sleep-wake rhythm is apparent, but however in which there is no evidence of awakeness or reactivity to the environment. The most commonly used labels, in the German and international literature, for these patients are ‘vegetative state’, ‘apallic syndrome’ and ‘coma vigile’. This clinical characterization is not sufficient. It is necessary to employ additional criteria to distinguish subsets of vegetative patients e.g. computerized tomography, magnetic resonance imaging, single photon emission tomography, electroencephalography, brainstem reflexes, evoked potentials, assessment scales, age, premorbid brain disorders. Diagnostic and prognostic parameters must form the basis for various decisions relating to patients' care and intervention.

Key Words:

• head injury
• coma
• apallic syndrome
• vegetative
• State

Additional information

Notes on contributors

K. Hagel

It is with great sadness that we have to inform the readership of the Journal that shortly after completing the final editorial work on this Special Issue, Professor Kalman Jacob Mann was seriously injured in a car accident and subsequently died.

Professor Mann was responsible for establishing the two Hadassah Hospitals and Community Health Centres in Jerusalem and for the past 20 years headed the Presidium of Yad Sarah, Israel's largest community based, volunteer operated organization which provides a spectrum of free or nominal cost home care services nation-wide.

We offer our condolences to his family and friends, and trust that this Special Issue stands as a testament to his work in the field.