Coma and brain stem death

Coma is a medical emergency; after resuscitation the cause must be defined and a prognosis provided. The situation is monitored using the Glasgow Coma Scale and appropriate biochemical, neurophysiological and imaging tests are performed. In this article an algorithm for the examination and assessment of the patient in coma is provided. Common syndromes are identified and the process of investigation is explained. Those factors which help determine prognosis are described and the terminal conditions of brain stem death and persistent vegetative state are defined.