**Neurological Critical Care**

**Chapter 5**

**Provisional chapter**

**Important Issues in Coma and Neuromonitoring**

**Important Issues in Coma and Neuromonitoring**

DOI: 10.5772/intechopen.79448

Coma is defined as a state of unconsciousness and lack of response to noxious stimuli. The physiopathology of consciousness and coma is not entirely understood. On the other hand, clinical examination does not give us enough information in all types of coma states. In this chapter, some types of coma and their definition, the necessity of coma monitoring and what we can use for coma monitoring in ICU, algorithms for EEG monitoring, BIS, AppEntropy, permutation entropy and auditory evoked potentials are described. Burst suppression state new theories and cortical connectivity and reactivity

**Keywords:** coma status, burst suppression, cortical connectivity, cortical reactivity

Coma is defined as a state of loss of consciousness and lack of response to external stimuli that occurs in pathological states and during anesthesia. The prognosis of coma patients is difficult to assess, as the mechanism through which coma occurs is not entirely understood. What we may do is evaluate cerebral function, through accurate and careful monitoring. Thus, the intensive care specialist requires one or several instruments to monitor the cerebral function of coma patients, as it is difficult to perform, even hourly, a clinical evaluation, taking into

In certain circumstances, a worsening neurological state does not manifest itself clinically an example being nonconvulsive status, which has negative prognostic value in the case of traumatic brain injury (TBI), and can only be diagnosed through continuous electroencepha-

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

during coma as a tool for coma prognosis will be on focus.

http://dx.doi.org/10.5772/intechopen.79448

Bogdan Pavel

Bogdan Pavel

**Abstract**

**1. Introduction**

account the typical workload of the doctor.

lographic monitoring (EEG).

#### **Important Issues in Coma and Neuromonitoring Important Issues in Coma and Neuromonitoring**

DOI: 10.5772/intechopen.79448

#### Bogdan Pavel Bogdan Pavel

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.79448

**Abstract**

Coma is defined as a state of unconsciousness and lack of response to noxious stimuli. The physiopathology of consciousness and coma is not entirely understood. On the other hand, clinical examination does not give us enough information in all types of coma states. In this chapter, some types of coma and their definition, the necessity of coma monitoring and what we can use for coma monitoring in ICU, algorithms for EEG monitoring, BIS, AppEntropy, permutation entropy and auditory evoked potentials are described. Burst suppression state new theories and cortical connectivity and reactivity during coma as a tool for coma prognosis will be on focus.

**Keywords:** coma status, burst suppression, cortical connectivity, cortical reactivity
