A cotton swab to the nose, a startling noise near the ear — doctors have a few tricks they try when a patient suffering from a brain injury appears unresponsive. If the patient remains silent and unmoving, they can be labeled as totally void of awareness; in a sense, gone.
From coma to vegetative state, the condition can come in a variety of forms.
“We know we missed people,” Dr. Nicholas Schiff, a Weill Cornell Medicine neurologist, told NBC News. Schiff recently authored a potentially landmark study on brain-injured patients, discovering at least 25% of those unresponsive could still be with us.
Despite not physically responding to stimuli, the study showed that a significant portion of the 353 observed patients who appeared to have lost consciousness were actually capable of responding within their brains — a phenomenon referred to as “cognitive motor dissociation.”
“We also know that patients who have severe brain injury have what are called fluctuations in arousal,” Schiff added. “They have good and bad times of the day.”
Of 240 patients previously diagnosed as being in a coma, vegetative state or showing “minimal consciousness,” 60 showed evidence of “covert awareness.” The neurologist said he believes 25% is a conservative estimate for how many unresponsive brain injured patients are capable of such awareness.
“It’s both an incredible finding, but also kind of scary,” Caroline Schnakers, assistant director of the Casa Colina Research Institute, told NBC News. She was not involved in the study, but independently studies the phenomenon of cognitive motor dissociation and covert awareness.
That’s why, Schnakers added, new innovations in treatment, like brain implants, are a must.
“The family will ask, ‘What can we do?’ It’s actually something that we have not thought about very seriously,” she said, adding, “This is not acceptable anymore.”
According to the Atlanta-based Centers for Disease Control and Prevention, traumatic brain injuries led to 214,110 hospitalizations in 2020 and 69,473 deaths in 2021. It’s a stark statistic that represents 586 daily hospital admissions and 190 fatalities each day.
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