Outcome of post-traumatic unawareness persisting for more than a month

From 1986 to the end of 1991, 19 patients with persisting post-traumatic unawareness were admitted for rehabilitation. Criteria for admission were head trauma, Glasgow coma scale score < or = 8 points, and at least a one month duration of unawareness. Out of 19 patients, 12 patients (63%) regained consciousness, 11 patients (58%) within the first year and one patient (5%) within the second year. The mean duration of unawareness in the patients who recovered consciousness was 190 (range 62-440) days. In the recovery group, according to the Glasgow outcome scale, seven out of 12 patients (58%) were moderately disabled and five (42%) were severely disabled at the moment of discharge from rehabilitation. All the 12 patients who regained consciousness live with their families, and none had to be kept in an institution. The data confirm that awakening from post-traumatic unawareness is possible after a long period. Therefore, post-traumatic unawareness persisting for more than a month should not be considered an irreversible condition, because an outcome that might be regarded by some as being acceptable is possible even in patients with very severe brain damage.