Facts About Vegetative and Minimally Conscious States After Severe Brain Injury

Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium, Model Systems Knowledge Translation Center
Facts About the Vegetative and Minimally Conscious States After Severe Brain Injury

Severe brain injury causes a change in consciousness. Consciousness refers to awareness of the self and the environment. Brain injury can cause a wide range of disturbances of consciousness. Some injuries are mild and may cause relatively minor changes in consciousness such as brief confusion or disorientation.

The most severe injuries cause profound disturbance of consciousness. Twenty to 40% of persons with injuries this severe do not survive. Some persons who survive have a period of time of complete unconsciousness with no awareness of themselves or the world around them. The diagnosis given these people depends on whether their eyes are always closed or whether they have periods when their eyes are open. The state of complete unconsciousness with no eye opening is called coma. The state of complete unconsciousness with some eye opening and periods of wakefulness and sleep is called the vegetative state. As people recover from severe brain injury, they usually pass through various phases of recovery. Recovery can stop at any one of these phases.

Characteristics of coma

  • No eye-opening
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Characteristics of the vegetative state

  • Return of a sleep-wake cycle with periods of eye opening and eye closing
  • May moan or make other sounds especially when tight muscles are stretched
  • May cry or smile or make other facial expressions without apparent cause
  • May briefly move eyes toward persons or objects
  • May react to a loud sound with a startle
  • Unable to follow instructions
  • No speech or other forms of communication
  • No purposeful movement

Persons in coma or vegetative state require extensive care that may include:

  • Feeding using a feeding tube
  • Turning in bed to prevent pressure sores
  • Special bedding to help prevent pressure sores
  • Assistance with bowel and bladder relief using catheter and/or diapers
  • Management of breathing such as suctioning of secretions; this may include care for a tracheostomy tube
  • Management of muscle tone (excessive tightness of muscles)
  • Special equipment that may include a wheelchair or special bedding to help with proper posture and decrease muscle tightness
  • Management of infections such as pneumonia or urinary tract infections
  • Management of other medical issues such as fever, seizures, etc.

What happens after coma and vegetative state?

When people start to regain consciousness, they may:

  • follow simple instructions from others such as, “Open your eyes,” “Squeeze my hand,” “Say your name,” etc.;
  • communicate by speaking words or by indicating yes or no by head nods or gestures; and/or
  • use a common object in a normal way such as brushing hair with a brush, using a straw to drink, holding a phone to the ear, etc.

Persons with brain injury transition through the period of unconsciousness and subsequent stages of recovery at a slower or faster rate, largely depending on the severity of injury. Those with less severe injuries may transition through these stages more rapidly and some of the stages described here may be poorly recognized or not occur at all. Those with very severe injuries may stall at one or another stage and not be able to make the transition to a higher level of recovery.

For persons with more prolonged periods of unconsciousness, emergence from unconsciousness is a gradual process. Coma rarely lasts more than 4 weeks. Some patients move from coma to the vegetative state but others may move from coma to a period of partial consciousness. It would be very rare for a person to move directly from coma, or vegetative state, to a state of full consciousness.

Persons who have shorter periods of unconsciousness likely had less severe brain injuries initially. Consequently, they are likely to go on to make better recoveries than persons who had longer periods of unconsciousness.

Traumatic brain injury refers to damage to the brain caused by external force such as a car crash or a fall. About 50% of persons who are in a vegetative state one month after traumatic brain injury eventually recover consciousness. They are likely to have a slow course of recovery and usually have some ongoing cognitive and physical impairments and disabilities. People in a vegetative state due to stroke, loss of oxygen to the brain (anoxia) or some types of severe medical illness may not recover as well as those with traumatic brain injury. Those few persons who remain in a prolonged vegetative state may survive for an extended period of time but they often experience medical complications such as pneumonia, respiratory failure, infections, etc. which may reduce life expectancy.

People who have a slow recovery of consciousness continue to have a reduced level of self-awareness or awareness of the world around them. They have inconsistent and limited ability to respond and communicate. This condition of limited awareness is called the minimally conscious state.


Characteristics of the minimally conscious state

  • Sometimes follows simple instructions
  • May communicate yes or no by talking or gesturing
  • May speak some understandable words or phrases
  • May respond to people, things, or other events by:
    • crying, smiling, or laughing;
    • making sounds or gesturing;
    • reaching for objects;
    • trying to hold or use an object or
    • keeping the eyes focused on people or things for a sustained period of time whether they are moving or staying still.

People in a minimally conscious state do these things inconsistently. For example, one time the person might be able to follow a simple instruction and another time they might not be able to follow any instructions at all. This makes it difficult to distinguish the vegetative state from the minimally conscious state.

While in a minimally conscious state, people need extensive care similar to that needed by people in a vegetative state.


Emergence from the minimally conscious state

Once a person can communicate, follow instruc tions, or use an object such as a comb or pencil consistently, they are no longer in a minimally conscious state. Some people remain minimally conscious indefinitely, but many improve. The longer a person remains in a minimally conscious state, the more permanent impairments he or she is likely to have. This is because vegetative and minimally conscious states are caused by severe damage to multiple brain areas. Following emergence from the minimally conscious state, people almost always experience confusion. Sometimes people move directly from coma to this confusional state.


Comparison of Coma, Vegetative State, and Minimally Conscious State

 

Coma

Vegetative State

Minimally Conscious State

Eye Opening

No

Yes

Yes

Sleep/Wake Cycles

No

Yes

Yes

Visual Tracking

No

No

Often

Object Recognition

No

No

Inconsistent

Command Following

No

No

Inconsistent

Communication

No

No

Inconsistent

Contingent Emotion

No

No

Inconsistent


Characteristics of the confusional state

  • Disorientation (inability to keep track of the correct date and place)
  • Severe impairment in attention, memory and other mental abilities
  • Fluctuation in level of responsiveness
  • Restlessness
  • Nighttime sleep disturbance
  • 6. Excessive drowsiness and sleeping during the day
  • Delusions or hallucinations

As with the vegetative and minimally conscious states, the rate and extent of recovery from the confused state vary from person to person. However, almost all people who reach the confused state go on to make further progress. The main factors that determine the eventual degree of recovery are the initial severity of the brain injury and some types of additional medical problems. The shorter the time the person is in the confused state, the better the eventual recovery will be. Mild medical complications such as sleep disturbance or urinary tract infection may prolong the confused state but do not necessarily influence the final outcome.

Once the confusional state resolves, people are usually much better able to pay attention, orient themselves to place and time, and retain memories for day to day experiences. Nevertheless, they are very likely to have some significant cognitive problems such as impaired memory or slowed thinking. These cognitive problems are likely to continue to improve as time passes. Some people make limited progress, while others make a good deal of progress.


Patterns of recovery after very severe brain injury

Some individuals rapidly emerge from coma and briefly remain in the minimally conscious state before recovering a higher level of consciousness with mild impairments. Others may have a longer period in the minimally conscious state after emerging from the vegetative state and then usually have a greater degree of long-term impairment. Occasionally, persons remain in the vegetative or minimally conscious state for an extended period of time and, in rare cases, these conditions may be permanent.

What treatments are used with people in the vegetative or minimally conscious state?

Currently, there is no treatment that has been proven to speed up or improve recovery from the vegetative or minimally conscious state. However, there is general agreement that the primary focus of medical care is to prevent or treat any factors that might hinder recovery (such as hydrocephalus, a build up of fluid on the brain, or use of sedating drugs for other conditions), and to preserve bodily health (such as treating infections or stiffness of joints). Medical facilities and clinicians vary in the extent to which they try various treatments such as medications or sensory stimulation to promote recovery of consciousness. Because the amount of recovery from disorders of consciousness varies so greatly, it is difficult to judge the value of these and other treatments outside of research studies. You can inquire about your physician or program’s philosophy about using these types of treatments.

Transitions to different levels of care

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. Initially, the person with severely impaired consciousness is most likely to be treated in an acute care hospital where the focus is primarily on saving his/her life and stabilizing him/her medically. Once that is achieved, the next focus is on recovery of function to whatever level is possible. Sometimes this happens in an acute rehabilitation hospital, which provides a high intensity program of rehabilitation services, including physical therapy, occupational therapy, speech and language therapy, recreational therapy, neuropsychological services and medical services.

Some patients do not transition from the acute care hospital to an acute rehabilitation program. These people may go directly to a skilled nursing facility, a sub-acute rehabilitation program, a nursing home, or even home with family. Persons discharged from an acute rehabilitation program usually go to one of these places as well. Skilled nursing facilities, sub-acute rehabilitation programs, and nursing homes vary widely in the quantity and quality of medical management, nursing care, and rehabilitation therapy services they provide.

Many factors influence decisions about where a person with severe impairment of consciousness or other severe impairments may go after discharge from the acute care hospital or discharge from the acute rehabilitation program. Some of these factors are the person’s medical condition, health insurance coverage and other benefits, the person’s ability to tolerate rehabilitation therapies, the doctor’s philosophy about where people should go to continue to recover after severe injuries, the family’s ability to care for the person at home, the family’s wishes, and practical matters such as that the distance the family has to travel to visit the person at the facility.

The names used to describe levels of care and the settings in which they are provided, vary across the country. It is helpful to work with a social worker or case manager in the facility where your loved one is currently receiving services to plan whatever transitions are necessary. Do not be afraid to ask questions to make sure that you obtain the information you need to help you make the best possible decision.

Things to look for when considering a setting to care for your loved one:

At various points in the process of recovery, persons in the minimally conscious or vegetative state may receive care in a wide range of settings. These include in-patient rehabilitation facilities, skilled nursing facilities, and long-term acute care facilities. The following are some considerations for selecting a place for care:

  • Your family member’s current treatment team has had good experiences with the program when they have referred others there.
  • The staff at the facility makes you feel comfortable, is accessible to talk with about your concerns, and answers your questions.
  • The program and medical staff have experience working with the same kinds of problems that your family member has.
  • The facility is informed about the specifics of the care your loved one needs and is able to meet these care needs. You can have a role in ensuring that a detailed nursing plan of care is developed.
  • The program includes case management to assist in planning for the next level of service, whether it is transition to a rehabilitation program, a facility for long-term care, or home.
  • The program provides education and training for future caregivers.
  • The program uses specific procedures to measure progress.

If support services can be arranged, some persons in the minimally conscious or vegetative state can be cared for at home.


Thoughts from families who have been there

Family members who have a loved one in a minimally conscious or vegetative state have identified a number of important issues:

  • Communicating with healthcare providers
    Be sure to ask questions, share your observations, and express your opinions.
  • Managing medical equipment and supplies
    It is important to be knowledgeable about your loved one’s equipment and supplies, and know how to communicate with the companies who provide these items.
  • Providing care
    Family members often provide some of the care for their loved ones. The amount of care you provide will depend on your role in providing care (this can range from providing most of the care yourself to simply directing the care provided by others), the people such as sitters, attendants, nurses, and family members who are available to help you with providing care, the setting (this could be your home or a skilled nursing facility), and the guidance you receive from health care providers. It is desirable to obtain as much training as possible to provide whatever elements of care you chose to provide and are able to manage. These might include bathing, grooming, bowel and bladder management, mobility, range of motion, and other medical issues that your loved one may have.
  • Learning about financial resources
    You may initially feel overwhelmed when you start to learn about various financial resources that may be appropriate for your loved one. However, with patience, persistence, and some help from others, you will be able to figure out which programs apply and find your way through the application processes.

    Programs you will want to learn about include:

    • Healthcare programs such as Medicare and Medicaid.
    • Income replacement or financial assistance programs such as SSDI (Social Security Disability Insurance), SSI (Supplemental Security Income), or possibly disability insurance policies that you loved one may have had through work.
    • Services to help with community living such as state agencies that assist people in these areas.

    It might not be possible to find someone who knows everything about how to access these various services and programs. The key is to keep asking questions and following up to make sure that you and your loved one get all the benefits that are available. People who may be helpful to you are social workers, therapists, case managers, the local social security office, your state brain injury association chapter, family members or friends who are disabled or who have family who are disabled, or the human resources (personnel) department at your loved one’s employer.

  • Guardianship
    Since your loved one is not able to fully make decisions for himself or herself, it may be helpful for you, or someone else, to be appointed guardian. This may make it easier to handle medical decision making or management of your loved one’s financial matters. If you think that your loved one may need to have a guardian appointed, you will need to contact an attorney to get assistance. Guardianship can be reversed when it is no longer needed.

How to interact with your loved one who is unconsciousness or at a low level of responsiveness

The most natural way of interacting is to talk to your loved one, even though he or she may not respond or understand. Simple things like telling him or her about recent events in your life, what is going on in your family or neighborhood, or the latest news might make you feel a sense of connection. Talking with your loved one about what you are doing as you provide care can increase your comfort with the process of care giving. For example, telling your loved one that you are going to move his or her arms and legs to help prevent joint tightness might make you feel more comfortable with this task. Only do this “range of motion” type activity if you have been instructed to do so by the doctor, nurse, or therapist.

Physical touch is another way of having a sense of connection. Some family members have said that the act of giving a massage or applying lotion to the hands or face helps them to feel close to their loved one. It is also important to avoid the risk of overstimulation as this may result in rapid breathing, tightening of the muscles, grinding of the teeth, restlessness and fatigue.


Taking care of yourself and other family members

Family members of a person in a vegetative or minimally conscious state often feel a sense of loss or grief for the relationship they had prior to the injury. There can be a number of ways to cope with these feelings. A person in a minimally conscious or vegetative state may make very slow progress or go for periods of time with no apparent progress. Sometimes keeping a journal of the changes you have observed may be comforting. This may give you a chance to look back and see ways in which he or she is more able to respond than he or she was at an earlier point in time.

Having a loved one who is in a vegetative or minimally conscious state can be physically and emotionally draining. Managing this alone can be too much to ask of one person. It is important to rely on support from others, looking to existing supports and developing new ones. You might find help from supports you have relied on in the past, such as family, friends, and religious groups.

Other resources to consider include support groups, support agencies, and the Internet. A good way to learn more about these possible supports is to make a contact with the Brain Injury Association of America’s National Brain Injury Information Center (www.biausa.org, 1-800-444-6443) and obtain contact information for the closest state brain injury association (BIAA) chapter. Health care providers such as doctors, therapists, social workers and others can be good sources of information about supports available to you.

Even the most committed caregiver needs to have some private time. If your loved one is at home, this can range from having a friend or family member give you a 2 hour break to go do something for yourself to having full time caregivers for a week or having your loved one spend a brief time in a nursing care facility or hospital. If your loved one is still in the hospital or living in a nursing care facility, having a rotating visitation schedule can give you some breaks while giving other friends and family a chance to spend time with him or her.

When your loved one was first injured you were likely to be in crisis mode, focusing on the problems and putting the rest of life on hold. As time goes by, you will need to shift from crisis management mode, and begin to take care of the concerns of everyday life such as paying bills, maintaining relationships with other family members, and taking care of your own physical and mental health. While it is natural to focus on your injured loved one, other members of your family will have needs too. For some people, formal counseling with a therapist or member of the clergy can be an important part of making adjustments to life changes that have occurred as a result of your loved one’s injury.

While caring for a person in a vegetative or minimally conscious state is an enormous challenge, use of appropriate resources, as described above, can be a big help. Each person will respond differently to this challenge, but almost everyone can cope and move forward. Many family members have a deep sense of personal satisfaction in making life as comfortable and pleasant as possible for a loved one who has sustained a severe injury.


VS-MCS brochure authorship and acknowledgement:

Written by: Mark Sherer, Ph.D., Monica Vaccaro, M.S., John Whyte, MD, Ph.D., Joseph T. Giacino, Ph.D., and the Consciousness Consortium. Members of the Consciousness Consortium include:

  • JFK Johnson Rehabilitation Institute, NJ (Lead Center)–Joseph T. Giacino, Ph.D., P.I.
  • Moss Rehabilitation Research Institute, PA (Co-Lead Center)–John Whyte, MD, Ph.D., P.I. and Sooja Cho, MD, Site P.I.
  • Methodist Rehabilitation Center, MS–Stuart A. Yablon, MD, P.I.
  • Braintree Rehabilitation Hospital, MA–Douglas Katz, MD, P.I.
  • Sunnyview Hospital & Rehabilitation Center, NY–Paul Novak, MS, OTR, P.I.
  • Bryn Mawr Rehab Hospital, PA–David Long, MD, P.I.
  • Texas NeuroRehab Center, TX–Nancy Childs, MD, P.I.
  • Fachkrankenhaus Neresheim, Germany–Bernd Eifert, MD, Ph.D., P.I.

Acknowledgements: Funding for writing and publication of this brochure was provided by National Institute on Disability and Rehabilitation Research grant #H133A031713 (A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe Traumatic Brain Injury).

The Brain Injury Association of America (BIAA; www.biausa.org) provided feedback from the consumer perspective for the content of this brochure and is assisting with dissemination of these materials.

Several family members of persons with TBI generously gave their time and valuable insights to assist with the writing of this brochure.

Posted on BrainLine March 25, 2010. Reviewed March 28, 2019.
About the Authors

The Model Systems Knowledge Translation Center is operated by American Institutes for Research (AIR) and is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) under grant number 90DP0082. Four additional organizations support AIR in executing the work of the MSKTC, including George Mason University's Center for Chronic Illness and Disability, WETA's BrainLine, University of Alabama, INOVA, and American Association of People with Disabilities.

Sherer M, Vaccaro M, Whyte J, Giacino JT, & the Consciousness Consortium. Facts about the Vegetative and Minimally Conscious States after Severe Brain Injury 2007. Houston: The Consciousness Consortium. Copyright © 2018 by University of Washington/MSKTC. 

Please check the MSKTC site for any recent updates on this article.

Comments (273)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

My partner had a week in hospital where he was placed in an induced coma due to sepsis arising from liver disease. He appeared to be in a wakeful state when he was brought out of the coma, around 24 hours afterwards. His facial expression had changed from a peaceful sleep to slightly agitated, and he made minimal movements as if a bit restless. His eyes were strangely half-open all day, showing the whites, rather than becoming completely open. And that evening he started being sick over his shoulder, as if cognisant of the fact he must not be sick on his himself or choke. I was told this was a good sign, showing his brain stem was functional. The nurses had to clean him up repeatedly because he was sick (bringing up protein they had fed him through a tube into his stomach, and they syringed the liquid out and then removed the tube, stopping him from being sick again. His eyes were then closed, but the nurses told me he moved his head to one side repeatedly when they cleaned him up, as if they were concerned something had happened to him to cause that. My question is - when his eyes were half open, and he did not communicate, what does that mean about consciousness? There is no mention of ‘half-open’ on the Glasgow Coma Scale. Secondly, if he was able to judge to be sick over his shoulder, does that mean he was minimally conscious or still in a vegetative state? He hd to make a considerable turn of his body to achieve this. Lastly, slightly off topic - i have read that vomiting is sometimes a symptom of brain haemorrhage (which he died from, the nurses being rightly concerned about his head movement after cleaning). Might it have been that he was haemorrhaging much earlier in the day - hence his frown - and then being sick as a consequence? Or was it more likely it happened that evening, immediately prompting him to vomit? I am trying to understand how someone in a vegatitive state would likely react in a delayed or an immediate way, because I still have no answers into how the brain bleed occurred.

My cousin had a stroke five months ago when he was being taken to the hospital he was talking but when in hospital he went into coma. Now after five months he’s off oxygen his eyes are open for a brief time. I talk to him when i visit him sometimes i ask him to move his eyes and he does. I have no faith in the doctor or the nurses we can’t afford a good place. I just wonder if anyone has similar experience. I have confidence he will get thru this but I don’t have the patience because there’s no time. Is my cousin can wake up in a month five months that’s what gets me anxious.

This was very helpful. Thanks for the thoughtful and informative writing. Much appreciated.

Can anyone perhaps share their story or loved ones story with me if similar please.
Loved one 5 months post stroke thrombectomy and still has not opened his eyes, whilst he is responding to simple commands and gestures, speech is unrecognisable. Long term prognosis I do not know.

My spouse had a stroke little over two yes ago, she was in ICU for about a month. She was in a coma and now minimally conscious. She was fairly young at the time, 37, what are we looking at now? I'm hoping some change but nothing seems to change. Seems to be very little solid info on this.

Hello to everyone. I am Alex from Athens, Greece. On September 5th my 84 year old father fell from the stairs in a resort and was severely injured. The MRi showed a very severe brain injury with multiple bleeds and a big strain at the right part of the brain. He fell in a coma immediately after the fall (GCS 3). They kept him 2,5 months in the ICU and his prognosis was very poor mostly because of his age. When he came around from suppression he entered a vegetative state with eye opening only and no other reaction. After 3 months in the hospital we moved him to a rehabilitation center and four two months he still had no reactions but the eye-opening and a reaction to pain. Then in the end of January he started moving his right hand and he has an overall better mobility at legs. But this mobility is reflexive since he hasn t yet regained consciousness... Today we are closing seven months from his accident... Has anyone had a similar case? Did your person regained consciousness? Thank you

Hi Alex, My partner fell into a cardiac arrest 5 years ago and was resuscitated with adrenaline. He came back to life but he came back in a vegetative state. He has been unconscious for 5 years now being kept alive by tube by his parents. We had small things happen at the start but he has never progressed and now I am pushing to end his life. In my opinion and my journey, It is worth letting them go and pass over. The discord in the families and the burden it becomes on your life is something I am sure they would not have wished for. It a terribly complicated situation - but it has been 5 years and no change.

Hello to everyone. I am Alex from Athens, Greece. On September 5th my 84 year old father fell from the stairs in a resort and was severely injured. The MRi showed a very severe brain injury with multiple bleeds and a big strain at the right part of the brain. He fell in a coma immediately after the fall (GCS 3). They kept him 2,5 months in the ICU and his prognosis was very poor mostly because of his age. When he came around from suppression he entered a vegetative state with eye opening only and no other reaction. After 3 months in the hospital we moved him to a rehabilitation center and four two months he still had no reactions but the eye-opening and a reaction to pain. Then in the end of January he started moving his right hand and he has an overall better mobility at legs. But this mobility is reflexive since he hasn t yet regained consciousness... Today we are closing seven months from his accident... Has anyone had a similar case? Did your person regained consciousness? Thank you

My mother fell hit her head on fireplace stone. Massive brain bleed & they had to open her head to try & drain & stop the bleeding & swelling. She also suffered several strokes. Don't give my mother 76. It took her a year to start to read again. Not always but does she said it comes & goes. She was not able on her own to move her left side not 1 1/2 years since she's woken up she's moving her arm as of this past week! Doctors said it wouldn't happen after 6 months but it is now. She's slowly starting to move her toes. Her mind seems clearer as she goes .& she's remembering things more & more thought sometimes she starts to back slide asking something when you correct her she then remembers and corrects you. So don't give up. My hope u shell walk again.

My mom is currently in a vegetative state due to going into cardiac arrest and lack of oxygen. Doctors are telling us she has severe brain damage and is in a vegetative state. Lately when we see her we talk to her and hold and rub her hands and legs sometimes she opens her eyes and moves a little bit today my aunt said she lifted up and opened her eyes as if she was trying to get up I just want to know does that mean she's conscious in any way? The doctors said its from seizures but I'd like a second opinion.

I experienced the same with my partner who is now 5 years on in a persistent vegetative state. They can moan, wiggle a bit, cry, dribble, and make sounds maybe move there eyes but no one is home. As hard as it can be and what a test of hope and faith these states are! They are better off passing over. The heavy burden it becomes on your heart
and loved ones is not worth it.

Hi, the drs have said my mom is currently in a vegetive state after going into cardiac arrest as well. Her husband believes she’s at least minimally conscious. With Covid restrictions I’m not able to be there, where you able to get any clarity or are the drs right? TIA. -DS

My mom yust passed away July 14 this year 2020 on mger strouck I yust wunder I was talking to my mom on the phone told her I loved her and so on I wunder if she can hear me it yust gives me peace if I know thank you

My father had a brain tumor in the 70's..After surgery to try and remove it, a few days later he went into a coma..About 20 minutes before he passed away, i asked him if he could hear me, to squeeze my hand, which he did.

My niece is in somewhat of a coma after being overdosed before getting surgery to remove fluid from Brain well she reacts when we change her diaper or tickle her feet or even if I accidentally touch her with my hands cold she jumps or reacts but has no movement of eyes it will be a year on Friday June 5th what stage would she be considered under I have been reading up on so much but I’m not sure what she maybe.

Two and a half years ago, my dear friend (since 6th grade) and college roommate Nicky was a 2.5 on the Glasgow Scale following a heart attack and/or aspiration pneumonia in his sleep. He was in a coma for multiple weeks, then a nursing home for several months while we waited to see how his brain would respond. He still has some hearing trouble in his left ear, but that is the only noticable difference, at least to us. I couldn't be more grateful to tell you he is about 95% the same person he was before the ABI.

We didn't find much hope online for people with his prognosis...It happened in July 2017, and by August we were realistically expecting an indefinite vegetative state pinning all of our longshot hopes on stem cell advancements/legislation. The overwhelming love and support he received from his friends and family transcended the bleakness of modern medicine and the biophysical world, then Nickys brain did the rest...with plenty of help from a bunch of great (and a few god awful) medical professionals. Godpeed, and much love!

Wow that is amazing and I'm so glad your friend is on the road to recovery!

Sadly, my brother, who is 53, suffered an Atrial Fibrillation of the heart, which in turn caused a series of massive strokes, causing damage to 60-70% to his brain. He suffered the strokes around the 17th of Aug 2020 and was not found until a week later. He was in ICU for a week and has now been moved into a normal ward.

His prognosis is catastrophic and the Doctors don't give him any hope of recovering.

His now in a vegetative state and reading your story about your friend, gives me some hope for a miracle and that is all we can pray and hope for now... Thank you for sharing your friend's story, god bless!

Dear Eric,
Thank you so much for sharing your story. Currently my family is facing a similar situation on brain damage with vegetative state. Your comments on stem cell advancement raise my interest. Would you be able to share with me some links where i could get more information about this?
Thank you in advance

Hello Eric Posthumus,

Thanks for sharing the story. I'm so sorry for you and friend to get through all this.

i like your story

Five years ago I was induced coma for eight days. Those eight days I was dreaming. I believe god kept me talking and fighting for my life. They thought for sure. I would have brain damaged. I didn’t woke up thinking they were trying to kill me. Before that in my dream I was looking for my daughter julie. I seen beautiful trees just a lot of people that cared. I believed it was god doing that I’m here today. Took a year for recovery still can’t walk well. But I never walk good for the past 10 years. So people please don’t give up on your love ones. They here you and the doctors and so much more. So Thankyou god and my family and dear friends that never gave up on me.

I hope this isnt a rude question but can i just ask if you were dreaming in the vegative state or just during the coma? if you can remember that is, just looking for some comfort that my brother in law isnt suffering while he thrashes around/drools ect. it looks like agony, i hope his brain is protecting itself with something nice. it seems to be a very different situation though, he will most likely not fully recover. i pray every day that he even gets a little back, or passes away. nobody deserves to be stuck in-between.

My friend is beginning stages of waking from an induced coma. He was on his motorcycle and went to pass several cars, when one of them decided to turn left. He was traveling estimated 120mph when he hit the car that was turning. He flew through the air around 40 ft. He hit the ground before flying another 20 ft into a wall of railroad cross ties. That impact tossed him straight up into the air about 10 ft and then he landed on the gravel. This was April 8th, this year, 2021. And it was 2 days ago April 18th that he responded to the nurses commands and they removed his ventilator. He has opened his eyes a couple of times but not anything recent. He suffers a small brain injury, 5 broken ribs, a broken hip, broken ankle and finger. He also had a collapsed lung and a condition that causes the skin to separate and peel off from the muscle due to trauma. All odds have been against him. His motorcycle is unrecognizable. The motor was ripped from the frame. He should not be alive. But this is what I know without question. He has had the support and prayers from his friends and family throughout this process. The shear will and determination from all of us who love and care for him. Not giving up. Not believing there's a chance he won't pull through. This is the reason my friend is still here. You have to want it, feel them healed, and know it in your heart. I know my friend has a very long road ahead of him. But I know God isn't finished with him yet. I hope he will be here to share his story with you one day. Don't ever give up hope in what God can do. And when he doesn't provide you with what you desire. Know that he has a greater plan for us all. And have faith. May he bless each and everyone of you hear and your loved one. May they heal or end their suffering to be with him. And may your hearts be healed and blessed for those who's lives have been taken for his purpose. Amen.

My 19 year old diabetic niece was admitted to the hospital for severe pain. The next morning, the nurse found her in seizures and shortly after she went into a coma for a few weeks. It's been 1 year and 3 months since she's been in a vegetative state. She's been reacting to pain (won't let anyone straighten her fingers or hands), and cries when they're trying to find a vein for blood tests. She raises her neck off of the pillow for a few minutes, moves her legs and hands, smiles, stares at the screen when her favorite Kpop group is on. Unfortunately, she does not respond to any commands. She's had intense physical therapy in the first 4 months, but they gave up on her. She is now in a nursing home. She has a feeding tube and trach. We're still hoping that somehow she pulls through.

BLESS YOUR HEART. FKRVTAKING CARE BASICALLY . ALL DOC.. PROGNOSIS. ENDS LIKE THAT I DONT KNOW WHY?? DOCTORS HARDLY SHOW ANY COMPASSION THESE DAYS..AT TIMES YOU ARE BETTER DOCTOR THAN THEM

My son is 37 in same shape responds to pain hears us and blinks his eyes when we ask him if he knows us he's posturing a lot and they took away his therapy I'm not giving up either so hang in there

Hi
My sister is exactly the same

Two and a half years ago, my dear friend (since 6th grade) and college roommate Nicky Quayles was a 2.5 on the Glasgow Scale following a heart attack and/or aspiration pneumonia in his sleep. He was in a coma for multiple weeks, then a nursing home for several months while we waited to see how his brain would respond. He still has some hearing trouble in his left ear, but that is the only noticable difference, at least to us. I couldn't be more grateful to tell you he is about 95% the same person he was before the ABI.

We didn't find much hope online for people with his prognosis...It happened in July 2017, and by August we were realistically expecting an indefinite vegetative state pinning all of our longshot hopes on stem cell advancements/legislation. The overwhelming love and support he received from his friends and family transcended the bleakness of modern medicine and the biophysical world, then Nickys brain did the rest...with plenty of help from a bunch of great (and a few god awful) medical professionals. Godpeed, and much love!

My mother suffered a stroke almost 2 yrs ago and was responsive when brought into the ER so much so that we left the hospital for a little bit to go home. Just as we reached home, we received a call from the hospital that she was om distress due to the accumulation of blood in her head. Since her health was too precarious to perform surgery they gave her medication which reduced the clots. When we got to the hospital and she was put in ICU and intubated. My mother was still aware at this point and able to follow commands. She was intubated for 7 days and they said that they were going remove it because she couldnt be with it for too long. When they tried to take it out it caused her distress so they said that at this point that a trach was needed. They explained that it didnt need to be a permanent thing but that it would help her breath and that if she did well further down the line they would be able to do away with the trach. Well this was the beginning of out nightmare. We let them perform the tracheostomy (sp?) and all went well so much so that when she came out of sedation she was fighting with the nurses but as time went on I noticed that she was sleeping alot. I mentioned this to the doctors and they said it was the effect of the anesthesia. I still felt uncomfortable so I mentioned it to the nurse who also thought that it was strange. My gut feelings were right, she suffered a stroke after surgery which the doctors were not able to catch. They said that she was in a coma and that we had to make life changing decisions. They basically were saying that she was vegetable and that there was nothing to be gained from continuing her care. Although we dont always get along as a whole my siblings and I all came to the agreement that we would not accept the doctors diagnosis. We tried to change her to a better hospital but her situation was so precarious no hospital was willing to take her. We were forced to give her a feeding tube and transfer her to a (SNF). She is currently at a really good facility that has amazing staff. While she still has a trach and is unable to care for herself, she is able to watch tv, move one of her legs when I'm massaging it and look at people. They have tried to wean her off the vent but she gets to a certain point where she goes into distress and is unable to tolerate it so they end up putting her back on 100% assistance. We have explained to the doctors that we have to find a happy medium where she is able to tolerate breathing on her own in increments. Some of these doctors are all or nothing, its either black or white for them no in between. The doctors also say that she is unresponsive when they visit her, meanwhile they come in for like 5 mins and make a prognosis. When guests have visited my mom she squeezes their hand or cries. I want to know if I'm being unrealistic. I know that she will never be the same but I refuse to deprive my mother of care because they have given up on her. I still have faith and belief in miracles. Has someone been in a similar situation with words of advice.

Hopefully by this time all is very well with your mother's recovery. My aunt had suffered from an aneurysm then a similar fashion as your mother. After the surgery, she was coherent and talkative then the strokes occurred and now she sleeps. Her eyes open and close and also had a trichotomy for her to breath due to the fluid build up. We are scared as to her situation, she suffered 5 strokes and still at times open her eyes. Due to the covid scenario, we can't even visit to speak with her. It's heartbreaking because we can't see her. Your story was uplifting to her how your family found the care that was needed. Is there any advice you can give from your personal experience?

Hello Tamara how is she doing now? my prayers are with her

my mom is in exact same situation.i went against dr. prognosis..and she is conscious and. was nodding head when asked question..its terrible that A LOVED ONE MEMBER PLAY A BETTER.. ROLE THAN EVER A DR.WOULD.UNFORTUNATELY..WE PAY DRS TO DO THEIR JOB AS COMPASSIONATE AND CARING. SOME OF THESE DRS. NEED LEAVE THEIR PROFESSION. THAY GOT NO PLACE. IN HEALTH..

Hello how is your mom doing now prayers for her you can email me

I'm in the same position. God bless you and your family.

Hello Tamara!
I am totally agree and understand you ,I am in the same situation with mom and never lose my Faith or Hope and I believe in Miracles .
Only Jesus Cristos is a Saver and Trust Him as I do too.
Be Strong and Believe!
Your Mom will be in My Prayers too!

My mother suffered a massive stroke in Feb. She had a living will and my sister and I agreed that to see her bedridden, unable to respond in any way, and not being able to eat normally was going to be pure torture for her. We stayed with her for 5 days until she passed away. We are heartbroken with losing her, but are comforted in knowing we didn't put her through pure torture just so she could be alive with us.

I totally agree with you. Why put your loved one in this position. Firstly would you like to be in it? and secondly try put them before your emotional needs. my partner is in a vegetative state 5 years now! no change and his catholic mother has gone deranged. Everyone wants him to pass. I believe in god and miracles and i know if we pull all machines that is when he can do his work. I am currently in court trying to free his life. Its such a shit house situation and I feel for all people involved.

Does anyone have any input on how these patients affect the psychology in children, especially in small children. So the young child of the vegetative parent. Thank. you

My brother age 28 had a heart attack at work. We believe he was unresponsive for about 18 minutes. His coworkers found him and did CPR until the ambulance arrived which was 4 minutes later. Unfortunately due to us not knowing how long exactly he was unresponsive there is brain damage due to lack of oxygen to the brain. This happened about 7 weeks ago now. The doctors say he will be in a vegetative state. There is body movement and eyes opening but non on command. We do believe he hears us because we have asked him to move his arm or squeeze my hand and to us we believe he is listening because he has done it when we ask. Unfortunately he has not woken up but we continue to do exercises on him and talk to him. He also has a fever that comes and goes due to brain damage doctors say and the only way to control the fever is with ice packs or the cooling blanket. If any one knows of some one that has come out of this I would greatly appreciate the good news. We know this is going to be a long process but our family is hopeful that a miracle will happen.

My Father(84) had brain stroke and took him to ER. In ER After giving TPA, he improved. Doctor at ER said they want to check the damage and try to see the artery. They flew him in helicopter (surprised that they did that for brain stork patient). My dad threw up as soon as he came out. Still they performed the operation and try to expand artery which resulted in Major stroke...When we saw him after 8 hours, he was all cold with breathing tube and not responding. Doctor told us that he is in veg state and will not recover. Basically don't let them do surgery on 84 year old if TPA has worked. Anyhow, i did not want to give up... After 36 hours, he moved his right leg and we got hope.. After 2 weeks in ICU, he had improved where he opened his eyes and moved his right side. He also able to adapt on PMV for speech for short duration. After that we moved him to nursing home... Here he started having vomiting and headaches. Vomiting was due to incorrect tube in stomach which resulted in air.. After fixing that, vomiting reduced but did not go away.. With very small feeding amount of 40ml/hr, he is opens his eyes for short time and shows headaches.. At this point, after 7 weeks, we are stuck.. He got worse compare to ICU.. Not sure if we take him back to ICU to treat his headache or keep him in nursing home. Nursing home staff is good with trac patients but don't have neuro experts... As time passes, he will miss out on PT/OT due to not having energy and drowsiness whole day. Please let me know if you have come across such situation and any solution had worked for you.. Thanks.

Keep hope alive. My father went into cardiac arrest following a surgery. 1/28/19. He went through that phase. He is still recovering and fights daily. Keep a journal and don't get discouraged. Don't allow doubters to get you down. Always fight for him. I spend a lot of time defending to others what I have witnessed my father do. I will keep you all in my prayers. Hang in there. It's hard when no one has the answers.

My best friend was in a motor accident.an its been 9 days.he is on life support.on the 4th day he went from zero brain activity to level 1 rem sleep.but has made zero improvments since then.the family is taking him off life support an making this choice as the dr.s said they thing he will be all the way vegi state or brain dead if he stays on the support.is this to early to find out this soon.should there be more time.so he is in a coma an doesnt open his eyes..thus is the 9th day...please any advise.

I am so sorry Chris. Currently I’m reading up on these similar problems which I am going through. For me, I’m the mother of my daughter, 46..so similar to your situation.
In my honest opinion, I won’t give up for quite a long time., can’t not when tears run down my daughters face. I truly believe there is always hope, but every family makes their own choices..

I want to say don't give up my mom fell hit her head had a massive brain bleed . The doctors opened her head & at somepoint suffered several strokes! The doctors told me to let her go. Evevery night from 12 @ night till 7 in the morning I was told let her go. They did an ekg that showed she had active brain function. But another doctor tried to say she was Brian dead! I said are you neurologist? Because I was there when one did the test. Then they said because she didn't open her eyes fast enough she's will be nothing but a vegetable or comatose. Well she did wake up. Her left side was not working.it was everything this forum describes. Up to last year she want able to read two days before Easter she started reading of the TV. She said it comes & goes. Wasnt able at all since her fall jan 4/19. I see s time goes on some things are getting better. Her newest she hasn't use her left arm since the accident. I worked many hours I got her hand flexing & finger tapping. But not her moving the Arm 1 1/2 years later shes moving her arm slowly but its moving. & now wiggling her toes. My question do I hold out hope since the arm now moves her leg might too.? My mom is 76. She will never be totally as she was but I'm glad I fought for her as this was her wish to be saved.

Hi can any one day me how pain full it is with more than half brain dead she speaks normal look normal but in the bed she can't move her one side leg and hand she is in bed for past 7years and now doctor says her half brain is dead and she is alive with her half brain she all ways keep asking me will I die with lot of pain how long will I live like this what is th really happening in me will my next half brain will die in once or slowly I don't have answer can anyone answer this Question pls

One week ago today (June 5th) my 67 year old mother suffered a choking accident and cardiac arrest and is currently in a coma (today is June 13th). My father did everything he could to help her in the moment. She was not breathing and her heart had stopped when the ambulance arrived. They were able to start her heart again on-route to the ER. She had been placed on a respirator immediately and had been heavily sedated. On Saturday (6/8) they started removing sedation and since she has not been given any. All of the neurological response tests performed showed no signs of voluntary reaction / cognitive brain function. The respirator is really doing most of the breathing for her but there are moments when she over breathes. She has had a fever since Saturday that hovers around 102, and have been told this is not from an infection but from brain damage. Her EEG came back with no brain activity. We are holding on to hope but have been told that she will no recover from this. We are trying to encourage the Dr's to give her alternative supplements and high dose vitamins to see if anything will help. They are refusing most, for FDA and liability reasons. We have also been told that she can only be on a respirator for about 2 weeks, which leaves us with one more week to decide if we want to have a tracheostomy & feeding tube put in instead. Then, we have to make additional decision about her care, and also how to afford everything. None of my family members want her to suffer or live a terrible quality of life. Has anyone experienced a similar situation, with a favorable outcome and partial/full recovery? I should also note that she was transferred from the ER to a local hospital that DID NOT have a neurologist on site! After questioning them to perform the EEG, they told us that there has been no neurologist there for months and she would have to be transferred to another hospital for that test. (They then moved her by helicopter to another ICU.) How can a patient with brain trauma be transferred to a facility incapable of appropriate care?!?

Hi I’m sorry about your mother & wondering how’s she’s doing now? I know it’s an older post but going through a similar situation with my 69 year old father. Any advice would be very helpful. Thanks

My sincerest empathy is with you. My 62yo father was rushed to the hospital on veterans day 11/11/2019 having severe chest pains. they rushed him to the cath lab and placed 2 stints and put in an emeplla device. He was as stable as he could be when we left him at the hospitable. at approximately 340 am that next morning, he went asystole and was without adequate O2 to the brain for almost 20 mins when they were able to get him stable again. They kept him in a medically induced coma for a few days until they took the empella device out. after they they tried to wein him from the sedation meds and wake him but was unsuccessful each time. his LVEF was 10% then increased to 20 and eventually got upwards to 30% and i remained hopeful that my dad would pull through. however, his kidneys started failing and he began having issues with the O2 stats dropping. One of the Drs had mentioned a CT and i asked why they hadnt done one to see what type of brain damage we may be facing and i was told it was too soon. I stayed with him every night for 11 days until i couldnt stay awake and would then drive an hour home. On Friday 11/22/2019 i came in that morning and was finally told they would be doing a CT and EEG. It wwas about time because my main concern with wanting one done was his brain function; i knew he was either being kept drugged or he had suffered some brain damage because his pupils were always pinpoint and he maintained a vegetative state even after they brought him out of the medically induced coma. My fears were realized when they advised us that he had suffered a severe stroke at some time and if he were to come out of this, he would be bedridden and full supportive care, to include the ventilator.
My grandma and myself made the horrific decision to set him free and stop the machines.... My father would not want to live that. We buried him the day before thanksgiving.

Whatever decision you make, I pray you keep your loved one in mind and what they would want. My heart goes out to you while you contemplate what you have to do.

My thoughts and prayers are with you doing this difficult time. Keep praying for your mom. My 26 yr. old cousin had a stroke and heart attack on January 4. 2019 and was in a coma for eight days. She lost oxygen to her brain for seven minutes and had multiple seizures. Soon after, she progressed into an unconscious wakefulness state for three months. As of today, June 20th she is now slowly coming around. I believe she's in the minimally conscious state because she is starting to mumble, say a few words and recognize family members. While she is not completely out of the woods, she is making progress. Her mother never gave up hope even when the doctors told her there was nothing that they could do for her. She was transferred to several different long-term nursing facilities and we were told that she would be severely disabled if she ever come out of MCS. The nursing facility has transported her to the hospital for blood transfusion, but they are planning to send her to rehabilitation. On this miraculous account, I would say anything is possible. Don't give up things can turn around.

on 17th june 2018 , my brother is 20 years old, had an electric shock that made his heart stopped for almost 20 mints and because of this his minimally conscious state now for almost 10 monts due to lack of oxygen was deprived that time his heart stopped. we can see improvements for sure he breaths now by his own and he blinks his eyes randomly and move his hand and leg by his own but still no following the commands :(

On November 20, 2018, my fiance age 39, had a car accident and had to be airlifted to the University of Mississippi Medical due to a brain injury and a broken hip in three places. He had surgery on November 26, 2018, to repair his hip and on November 27, 2018, physical therapy came in to do therapy on him and when he got up out the bed he became dizzy and nauseated, so they laid him back down in the bed. He kept complaining of being nauseated and later begin to vomit. He got up to go to the bathroom and fell on the floor, about 2 to 3 minutes later he began to have a seizure and stopped breathing for quite a period of time, which caused him to have an anoxic brain injury because of the lack of oxygen to his brain. On January 15, 2019, I noticed that when I moved around in the room, he would follow my movement with his eyes. When I asked him did he understand what me and what I was saying to blink twice he will. He does not follow commands like move your hands, legs, or arms, but he will move them on his own at times. Do you think that he will have a full recovery after this anoxic brain injury or does it depend on him?

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