What Does Vegetative Status Mean?

It was not until the 1970s that two well-known neurologists, Brian Jennet and Fred Plum, decided to make the first scientific description of this disorder. Since then, several articles have been published in the field of medicine analyzing the vegetative state from different perspectives. However, some controversial issues remain to be discussed in the industry.

In this article, we want to delve deeper into the most important aspects of the vegetative state and tell us what this disorder really is all about, what symptoms it presents with, and what its diagnosis and prognosis are.

What is a vegetative state?

In order to better explain this medical disorder, we need to divide the brain into two different parts according to the areas they control:

• The hemispheres of the brain control thinking and behavior by making us aware of ourselves and our environment. There are different blocks of the brain: the forehead or frontal block, the main or parietal block, the temporal or temporal block and the occipital or oxypital block. Each brain block has its own functions performed by neurons located in the cortex.
• The midbrain, which consists of the thalamus and hypothalamus and the brainstem, controls many vital functions. These functions include periods related to sleep and wakefulness, body temperature, breathing, blood pressure, and heart rate. This part of the brain is fortunately, so to speak, the primitive side of our brain.

The vegetative state is a long-term disorder that occurs when the hemispheres of the brain cease to function. For the same reason, that person also ceases to be aware of himself and his environment. However, the primitive brain, which maintains vital functions, is not affected by the vegetative state.

What causes the vegetative state?

There are several different causes for a vegetative condition, as any disorder that leads to brain damage can cause this condition.

Normally, a vegetative state occurs when, after brain damage, the brainstem and midbrain continue to function, but the same does not occur with cortical or cortical functions.

The most common causes leading to a vegetative state are:

• Head trauma: For example, a motorcycle accident in which a cyclist has not had a helmet and is hit in the head in an accident.
• A disorder that takes oxygen away from the brain, such as cardiac arrest or respiratory arrest.
• Cerebrovascular disease: For example, a cerebral artery becomes blocked, causing blood to drain and leading to a stroke.

Other causes may include tumors, cerebral hemorrhage, inflammation in the brain, and late stages of memory disorders such as Alzheimer’s disease. These disorders do not damage the primitive brain, but in turn damage the cortex and its functions.

Symptoms of vegetative state

People in the vegetative state can do some things that make us think they might be aware of themselves and their environment, such as:

• Open your eyes. The patient may alternately sleep with his eyes closed and sometimes with his eyes open again.
• For example , they can breathe, suck, chew, cough, poop, swallow, and make some sounds.
• Patients can even react to strong stimuli, such as high noise levels, and sometimes can also look just as if they are smiling or looking resentful.

The primitive brain performs these reactions without the person himself being aware of these activities or the things that are happening around him. These expressions, sounds, and movements are the result of unintentional basic reflexes that we all do.

How can we be sure that they are not aware of their environment?

In order for us to determine whether someone is aware of their environment or not, their actions must have a purpose. This intention shows that it has to do with what is happening around man:

• The patient can open and close his eyes and perform eye movements, but these movements and actions have no purpose. The movements are random and independent of the stimuli around the patient. For example, if a patient’s eyes are open and we place the pen in front of his or her eyes, the movement of the eyes will not follow the movement of the pen if we begin to move it.
• The patient does not perform voluntary or intentional motor movements. If he makes a gesture or raises his arm or leg, for example, the reason for this is a reaction to the strong stimuli that the environment offers him. They can be, for example, wake-up reflexes and startles that react to some loud sound. Other movements, such as sucking, chewing, or swallowing, are all primitive reflexes controlled by the primitive side of our brain.
• The patient is unable to speak and does not utter words. If the patient makes noises, it is usually a growl or other primitive noises.
• If an oral or written order is given to a patient, he or she will not follow or respond to it.
• The patient has urinary and faecal incontinence.

From these signs, we can see that the patient is not aware of himself or his environment, but his heart and lungs are still functioning normally. In other words, the body and the primitive side of the brain are still able to maintain vital functions such as blood pressure and the pace of the heart and breathing.

Diagnosis of vegetative state

The diagnosis of a vegetative condition is based on the symptoms assessed by a doctor. Even if a patient experiences all the symptoms of a vegetative condition, it is essential that the patient be observed for a period of time to confirm this condition. Without this method, it is possible to ignore some signs of a conscious state.

Imaging tests can also be performed on the patient to find out which part of the brain is affected by the brain damage, and based on this, it can also be seen whether that condition can be treated. To measure brain function, your doctor may use various tests, such as functional magnetic resonance imaging or an electroencephalogram, to determine if there is any activity in a patient’s brain.

Unfortunately, these tests are unable to detect the amount of patient consciousness. They allow doctors to simply determine if there is an awareness in a patient’s brain that cannot be determined with the naked eye. These results, in turn, can influence long-term treatment decisions as well as the potential for improvement or improvement in the patient’s condition.

Forecast of vegetative status

Generally, a state of unconsciousness that has lasted for more than a month is considered a permanent vegetative state. However, it has been found that the cause of the vegetative state, its duration, and the age of the patient are factors that may alter this prognosis.

Some improvement may occur in the patient’s condition, although the vegetative condition has been considered permanent. However, improvement is always minimal and means significant after-effects for the patient as well as poor quality of life.

Treatment of vegetative state

People in a vegetative state need comprehensive care. In particular, medical staff must take the following measures:

• Preventive measures for immobility problems: Ulcers or cramps may occur in areas where the patient is supported. In addition, blood compresses in the blood vessels, causing blood clots or blood clots. To avoid these problems, the patient must be moved passively.
• Good nutrition: Nutrition is given to the patient through tubes that go through the mouth / nose into the stomach or directly into the stomach. Nutrients can also be administered intravenously.
• High-quality cleaning of equipment and washing of the patient to avoid infections.

Possibility of recovery

Recovery is unlikely in these patients. Doctors, the family, and sometimes the hospital ethics committee need to discuss how to treat the patient. The patient’s wishes about the quality of these treatments should be taken into account if they are known or have been listed in the patient’s own will.