Book contents
- Frontmatter
- Contents
- Foreword
- Preface
- Acknowledgements
- An appeal to doctors
- Traumatic decortication
- List of abbreviations
- 1 A syndrome in search of a name
- 2 Diagnosis
- 3 Epidemiology
- 4 Pathology of the brain damage
- 5 Prognosis for recovery and survival
- 6 Attitudes to the permanent vegetative state
- 7 Medical management
- 8 Ethical issues
- 9 Legal issues in the United States
- 10 Legal issues in Britain
- 11 Legal issues in other countries
- 12 Details of some landmark cases
- Epilogue
- Index
1 - A syndrome in search of a name
Published online by Cambridge University Press: 21 December 2009
- Frontmatter
- Contents
- Foreword
- Preface
- Acknowledgements
- An appeal to doctors
- Traumatic decortication
- List of abbreviations
- 1 A syndrome in search of a name
- 2 Diagnosis
- 3 Epidemiology
- 4 Pathology of the brain damage
- 5 Prognosis for recovery and survival
- 6 Attitudes to the permanent vegetative state
- 7 Medical management
- 8 Ethical issues
- 9 Legal issues in the United States
- 10 Legal issues in Britain
- 11 Legal issues in other countries
- 12 Details of some landmark cases
- Epilogue
- Index
Summary
When Jennett and Plum in 1972 coined the term persistent vegetative state, in a Lancet paper subtitled ‘A syndrome in search of a name’ (1), they were neither the first to describe this condition nor the first to propose a name. In 1899, Rosenblath had reported a 15-year-old tightrope walker who after two weeks in coma following a fall from his wire recovered ‘to become strangely awake’; he died after 8 months being tube fed in this state (2). In 1940, a German psychiatrist Kretschmer proposed the term the apallic syndrome to describe patients who were awake but unresponsive (3). As examples he described a case with a gunshot wound of both cerebral hemispheres and one of panencephalitis subacuta, thereby indicating that this state could result from either acute or chronic progressive brain damage. Although several authors in continental Europe have used this term (4) it has never caught on in English-speaking countries.
In 1952 an American neurosurgeon commented that when brain damage deprived patients of the intuitive and protective functions necessary for survival they rarely lived more than 2–3 weeks (5). However, he went on to describe five patients who had survived for months with periods of wakefulness without ever being aware, but he did not suggest a name for this state. In 1956, Strich reported the pathological findings in five cases from the Oxford Neurosurgical Unit who had what she called severe traumatic dementia (6).
- Type
- Chapter
- Information
- The Vegetative StateMedical Facts, Ethical and Legal Dilemmas, pp. 1 - 6Publisher: Cambridge University PressPrint publication year: 2002