title: Pathophysiology of acute coma and disorders of consciousness: considerations for diagnosis and management.
abstract: Disorders of consciousness are due to failure of the arousal system. In this review, the authors introduce the spectrum of disorders of consciousness and describe the structures, projections, and neurotransmitters involved in the generation and maintenance of arousal. Next, they discuss the neurologic diseases frequently associated with arousal failure. Evaluation of patients with disorders of arousal is summarized, including the neurologic exam, electrophysiological studies, biochemical testing, and imaging modalities. Finally, they review treatment options, including therapeutic hypothermia, medications, and deep brain and spinal cord stimulation.
authors.affiliation: Department of Neurology, Neurocritical Care, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: Bethany M
authors.initials: BM
authors.lastname: McClenathan
authors.forename: Nitish V
authors.initials: NV
authors.lastname: Thakor
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hoesch
mesh_terms: D001921:Brain / Q000473:pathology*; D003128:Coma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D003244:Consciousness Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D019468:Disease Management; D006801:Humans