Definitions, diagnostic criteria, and clinical assessment scales in disorders of consciousness.

Disorders of consciousness (DoC) are neurologic conditions characterized by severe alteration in level of consciousness. Categories of DoC may include coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state (MCS; can be further categorized into MCS+ and MCS- based on the presence or absence of language-related behaviors), emergence from MCS, confusional state or delirium, and cognitive motor dissociation (CMD). CMD is a recently defined condition in which the patient fails to demonstrate observable behavioral responses on bedside assessment but demonstrates covert cognitive processing on functional imaging or EEG studies.

Natural history of recovery and long-term outcome in critically ill patients with brain injury.

Purpose Of Review: To increase knowledge of the natural history of recovery and long-term outcome following severe traumatic brain injury (sTBI).

Recent Findings: Recovery of consciousness and complex behaviors that presage subsequent functional recovery frequently occurs well beyond the first 7 days after injury, which is typically the time period widely used in the ICU for prognostic decision-making and establishing goals of care for. Similarly, recovery of functional independence occurs between 1 and 10 years postinjury in a substantial proportion of patients who do not recover command-following during the acute hospitalization.

Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury.

Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine's 2022 report on highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care.