The Brain

  • Martin W. DünserEmail author
  • Ronny Beer
  • Sirak Petros
  • Mervyn Mer


The level of consciousness is the most important and sensitive clinical indicator of neurological function in a critically ill patient. Different levels of consciousness have been defined (Table 7.1). Coma arises from bilateral cortical or subcortical dysfunction and/or brainstem injury involving the ascending reticular activating system. Unilateral hemispheric lesions only cause coma if a contralateral hemispheric lesion pre-exists or transtentorial herniation with brainstem compression has occurred.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Martin W. Dünser
    • 1
    Email author
  • Ronny Beer
    • 2
  • Sirak Petros
    • 3
  • Mervyn Mer
    • 4
  1. 1.Department of Anesthesiology and Intensive Care MedicineKepler University Hospital, Johannes Kepler University LinzLinzAustria
  2. 2.Neurological Intensive Care Unit, Department of NeurologyInnsbruck Medical UniversityInnsbruckAustria
  3. 3.Medical Intensive Care Unit and Centre of Haemostaseology, University Hospital LeipzigLeipzigGermany
  4. 4.Divisions of Critical Care and Pulmonology, Department of MedicineCharlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences University of the WitwatersrandJohannesburgSouth Africa

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