Severe brain damage often results in extended periods of unconsciousness. This injury often results from car accidents, other types of trauma, or after the brain has been deprived of oxygen.

There are three states of unconsciousness known as coma, vegetative state and the minimal conscious state. The recovery from this form of brain damage is very variable between persons. Individuals often progress from one state into the next. The medical profession is still trying to understand why some persons with this type of brain injury recover and why others with similar a similar degree of brain damage do not.

Frequently individuals with severe brain injuries and disorders of consciousness are misdiagnosed as to their true level of consciousness awareness.

Definition of Coma:

Coma is a state of unconsciousness where the individual’s eyes remain closed and they cannot be aroused even with the use of stimuli. The eyes of the individual remain continuously closed despite the application of noxious stimuli and there are no sleep/wake cycles on EEG examination. A coma typically resolves in one to two weeks following a severe traumatic brain injury.

Vegetative State:

In this condition, an individual’s awareness of themselves and their environment is presumed to be absent and there is an inability to interact with others. The vegetative state frequently follows a person being in a coma. The diagnosis is made when there is no evidence of sustained or reproducible, purposeful behavioral responses to visual, auditory, tactile or noxious stimuli and no evidence of language comprehension or expression. Unlike a person in a coma, a person in a vegetative state does open their eyes and may have a sleep/wake cycle.

The chances of recovery dramatically diminish if a person remains in this state for at least three months following a non traumatic brain injury and a least twelve months after a traumatic brain injury.

Minimally Conscious State:

A person in a minimally conscious state has a severe altered level of consciousness but shows evidence of minimal, but definite behavior signs that they are aware of their environment or themselves. An individual often progresses from the vegetative state into the minimally conscious state as they recovery from their brain injury. The diagnosis of the minimally conscious state requires evidence of one or more of the flowing behaviors: 1) simple command-following, 2) intelligent verbalization, recognizable verbal or gestural “yes/no” response or 4) movements or emotional responses that are triggered by relevant environmental stimuli and cannot be attributed to reflex activity.

Several new brain imaging techniques known as functional MRI (fMRI) and positive emission tomography (PET) are providing the medical profession with assistance in determining what state of consciousness a person suffering from severe brain damage is in.

Retaining an experienced brain injury lawyer is an important step in obtaining adequate compensation for a severe brain injury. The New York brain injury attorneys at De Caro & Kaplen, LLP have frequently been called upon to represent individuals in various stages of consciousness and obtain proper compensation for this devastating brain trauma.

Glasgow Coma Scale

The Glasgow Coma Scale is perhaps the most widely used scale to gauge a person’s initial brain injury. It is frequently used to assess individuals who are unconscious or in a coma. It was developed in Glasgow, Scotland and has gained widespread acceptance. Many studies have shown that the lower the initial scale of a person, the poorer their long term prognosis is.

Eye Opening Response

• Spontaneous--open with blinking at baseline (4 points)
• To verbal stimuli, command, speech (3 points)
• To pain only (not applied to face) (2 points)
• No response (1 point)

Verbal Response

• Oriented (5 points)
• Confused conversation, but able to answer questions (4 points)
• Inappropriate words (3 points)
• Incomprehensible speech (2 points)
• No response (1 point)

Motor Response

• Obeys commands for movement (6 points)
• Purposeful movement to painful stimulus (5 points)
• Withdraws in response to pain (4 points)
• Flexion in response to pain (decorticate posturing) (3 points)
• Extension response in response to pain (decerebrate posturing) (2 points)
• No response (1 point)

Categorization:

Coma: No eye opening, no ability to follow commands, no word verbalizations (3-8)

Head Injury Classification:

• Severe Head Injury----GCS score of 8 or less
• Moderate Head Injury----GCS score of 9 to 12
• Mild Head Injury----GCS score of 13 to 15

Brain Injury Legal Assistance:

The brain injury lawyers at the New York based brain injury law firm of De Caro & Kaplen, LLP understand these conditions and the tools for the evaluation of severe traumatic brain injury. If you or your spouse has sustained a traumatic brain injury as a result of an auto accident, bus accident, truck or train accident, construction site accident or fall, we can provide legal assistance to you.

We are based in New York and handle traumatic brain injury cases in New York City and throughout New York State including Albany, Long Island, Nassau, Rockland, Syracuse, Suffolk, Westchester and surrounding areas. With national affiliates, we can assist you with your brain injury case throughout the country.