Eelco F.M. Wijdicks, MD, Ronald E. Cranford, MD

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Clinical Diagnosis of Prolonged States of Impaired Consciousness in Adults Eelco F.M. Wijdicks, MD, Ronald E. Cranford, MD Mayo Clinic Proceedings Volume 80, Issue 8, Pages 1037-1046 (August 2005) DOI: 10.4065/80.8.1037 Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Article by Kretschmer1 that defined the term Das apallische Syndrom (apallic syndrome). Mayo Clinic Proceedings 2005 80, 1037-1046DOI: (10.4065/80.8.1037) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 Article by Jennett and Plum7 that defined the term persistent vegetative state. Mayo Clinic Proceedings 2005 80, 1037-1046DOI: (10.4065/80.8.1037) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Macroscopic specimen of the brain of a 23-year-old man who had been in a permanent vegetative state for 10 years after surviving massive brain edema due to Reye syndrome but died of bronchopneumonia. Brain weight is 370 g (similar to brain weight at birth). Top, Gross picture of brain in situ, showing marked atrophy of both frontoparietal areas. Middle, Gross picture of whole removed brain, left-sided perspective with marked frontal atrophy. Bottom, Coronal section of brain with marked cortical atrophy and hydrocephalus ex vacuo. Mayo Clinic Proceedings 2005 80, 1037-1046DOI: (10.4065/80.8.1037) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 4 Nonenhanced computed tomograms of the brain of a 45-year-old man after traumatic head injury showing profound cerebral atrophy with ventricular dilatation. When these scans were obtained, the patient had been in a permanent vegetative state for 15 years. Mayo Clinic Proceedings 2005 80, 1037-1046DOI: (10.4065/80.8.1037) Copyright © 2005 Mayo Foundation for Medical Education and Research Terms and Conditions