It has often been said that the only consistency in the outcomes for victims of traumatic brain injury is inconsistency. Predicting outcomes for those brain injured patients with disorders of consciousness (minimal awareness and vegetative state) has always been a challenge for clinicians specialising in this field. Patients’ loved ones are left bewildered and confused because they do not know what will happen to their nearest and dearest. This can often lead to families and doctors struggling with the most difficult ethical issues for treatment and end of life decisions.
However, following the publication today (16 April 2014) of a paper in The Lancet there is new hope - please click here. Doctors at the University of Liege in Belgium have published results of a four year trial of PET (positron emission tomography) scans and fMRI (functional Magnetic Resonance Imaging) of 126 patients and believe they have now found an effective way of assessing the outcomes for patients who have been in a vegetative state for more than a year. In these tests, levels of consciousness were identified in a third of unresponsive patients tested and most of these made significant improvement within 12 months of scanning. The study confirmed that PET scanning accurately predicted the extent of recovery within 12 months in 74% of patients scanned with fMRI scanning producing 56% accuracy. Unfortunately, these scanning methods are expensive and are unlikely to be universally available on the NHS for some time.
More importantly, the study also reveals disturbing statistics that more traditional methods of assessment have indicated that up to 40% of patients had been misdiagnosed. This can result in wrong clinical decisions being made.