Coma

Question 0

Loss of arousal due to

Answer 0

Focal bilateral damage in rostral midbrain and pons or caudal diencephalic, disrupting bioaminergic pathways

Question 1

Loss of awareness due to

Answer 1

Diffuse bihemispheric damage to cortex

Question 2

Causes of diffuse forebrain injury

Answer 2

Metabolic
Physical
Pharmacological

Question 3

Causes of focal brainstem injury

Answer 3

Destructive (bilateral vascular occlusion or hemorrhage)

Compressive (increased ICP from tumor or hematoma)

Question 4

Maximum overlap of coma induced lesions in

Answer 4

Para median tegmentum of midbrain and rostral pons

Question 5

Nuclei in the paramedian tegmentum of midbrain and rostral pons

Answer 5

Raphe nucleus 
Locus ceruleus
Laterodorsal tegmental nucleus (ACh)
Pontis oralis (glu)
Parabrachial (glu)

Question 6

Brainstem lesions that don’t induce coma

Answer 6

Unilateral rostral pons
Bilateral caudal pons
Bilateral medulla

Question 7

When person can move purposefully, follow simple commands, etc called

Answer 7

Minimally conscious state

Question 8

Locked in syndrome lesion in

Answer 8

Bilateral basal and tegmental pons

Question 9

Locked in syndrome spares

Answer 9

Cranial nerve 3 nucleus

Question 10

Brain death requirements

Answer 10

1) all brain function gone (no brainstem reflexes, no respiration, flat EEG) for at least 6 hours
2) cause determined and irreversible