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S evere 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 distur- bance of consciousness. Twenty to 40% of persons with injuries this severe do not survive. Some per- sons 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 unconscious- ness with no eye opening is called coma . The state of complete unconsciousness with some eye open- ing 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 2. Unable to follow instructions
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