The vegetative and minimally conscious states: diagnosis, prognosis and treatment.

Severe acquired brain injury has profound impact on alertness, cognition, and behavior. Among those who survive the initial injury, a significant minority fail to fully recover self and environmental awareness, and go on to experience prolonged disorders of consciousness (DOC) that can last a lifetime. Although there are no standards of care to guide clinical management, a growing body of empirical evidence is beginning to accrue to inform clinical decision making. In this article, we review the state of the science as it pertains to diagnosis, prognosis, and treatment of patients with DOC.