Altered States of Consciousness and TBI

The Law Office of David Dwork

Understanding the Difference Between Brain Death and Various Altered States of Consciousness Resulting From TBI

We Have all had Those Moments

Altered State Brain Injury

Someone is talking, we can see their lips moving, but we cannot understand what they are actually saying. It is information that is beyond our scope of knowledge. It can be difficult to fully comprehend a diagnosis delivered by a doctor as it pertains to a loved one that has suffered a Traumatic Brain Injury ( TBI ). The terminology of the medical profession can be very confusing, but don’t let it discourage you.

Let’s break down the altered states of consciousness due to a TBI. Here are some terms that are relative to the various altered states of consciousness as a result of a TBI:

The human brain has three main parts: the cerebrum, cerebellum and brainstem. In within these parts there are sections. Within the cerebrum for instance are those parts such as the cerebral cortex, that not only processes sensory and motor information but enables consciousness and self-awareness.

A traumatic brain injury can shut down these parts and/or entire sections which can prevent them from working altogether if the injury is serious enough. Thus causing the loss of consciousness or altered states of consciousness such as the following as noted in Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.

Clouding of consciousness is a very mild form of altered mental status in which the patient has inattention and reduced wakefulness.

Confusional state is a more profound deficit that includes disorientation, bewilderment, and difficulty following commands.

Lethargy consists of severe drowsiness in which the patient can be aroused by moderate stimuli and then drift back to sleep.

Obtundation is a state similar to lethargy in which the patient has a lessened interest in the environment, slowed responses to stimulation, and tends to sleep more than normal with drowsiness in between sleep states.

Stupor means that only vigorous and repeated stimuli will arouse the individual, and when left undisturbed, the patient will immediately lapse back to the unresponsive state.

Coma is a state of unarousable unresponsiveness. There are Grades I, II, III IV & V

All of these can vary to a certain degree, and offer hope of a chance for a partial to a full recovery.

What is Brain Death?

Patients who are clinically brain dead are no longer alive. There has been an irreversible cessation of all activity in both the brain and the brain stem. Reflexes that go through the spinal cord may persist even in a brain-dead state, but with no chance of revival.

This is an irreversible state. It also is the last chance for organ donation.

Family who have lost a loved one to a TBI that has led to brain death can make a decision that could save lives. This is the most crucial time to be informed and make a decision. There is no blood flowing to or through the brain, but as long as the ventilator remains in place, the organs such as the heart, liver and kidneys can still function for a short period of time.

Though your loved one can’t come back to life after brain death, they can make a difference in someone else’s existence.

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