Introduction

The assessment of patients in coma is a medical emergency. The cause should be identified and, where possible, corrected and the brain provided with appropriate protection to reduce further damage. It then becomes important to identify those patients for whom the prognosis is hopeless and in whom the institution or persistence of resuscitative measures is inappropriate, serving only to prolong the anguish of relatives and carers. It is frequently the neurologist to whom the physicians turn, to establish the prognosis of the individual in coma. It is therefore important that the neurologist in training develops a system whereby he or she can reasonably and accurately determine those factors which help in identifying prognosis and thereby provide reasonable advice to colleagues, paramedical staff, and the relatives and friends of the patient.

	DEFINING PROGNOSIS

The advent of cardiopulmonary resuscitation during the 1960s, together with the advances in intensive care medicine, created the need for . . . [Full text of this article]