Coma, Minimally Conscious, Vegetative State, or Brain Death – What’s the Difference?

Coma, Minimally Conscious, Vegetative State, or Brain Death – What’s the Difference?While any major injury can cause undue stress for a family, brain injuries are among the most difficult to endure. The victim of a traumatic brain injury often needs expensive medical treatments and may be unable to work for months or never again.

Traumatic brain injury (TBI), which may vary from very severe to mild, occurs when a sudden impact to the head damages the brain. According to the National Academy of Neuropsychology Foundation (NSNF), the most frequent causes of brain trauma are motor vehicle accidents and slip and falls. During a car accident or a fall, a person’s head can be subjected to violent forces, particularly if it strikes an object. Rapid acceleration and deceleration connected with a substantial blow to the head may transfer great force throughout the brain, leading to shearing (the tearing of the brain’s connecting nerve fibers).

Symptoms of brain injury

Traumatic brain injuries are sometimes not diagnosed immediately following an automobile accident. Although it can be difficult to recognize TBI, there are some warning signs to be aware of:

  • Confusion
  • Inability to remember recent events
  • Queasiness
  • Vertigo
  • Severe headache
  • Weakness or numbness on one side of the body

A TBI is classified as mild if loss of consciousness, confusion, and disorientation lasts less than 30 minutes, as compared to severe brain injury, which is associated with loss of consciousness of more than 30 minutes and memory loss that exceeds 24 hours. While a person with mild TBI (commonly called a concussion) might experience cognitive concerns, memory problems, inattention, and mood swings, a survivor of severe brain injury may be left in a responsive state with limited function of the arms and legs, irregular speech or language patterns, and lack the ability to concentrate.

Sufficient force can affect the regions of the brain that are responsible for consciousness and awareness, and may cause loss of consciousness, coma, or even brain death. Here are some of the conditions that can result from a TBI:


A coma is the state of continued loss of consciousness. The common symptoms of coma include:

  • Eyes are closed.
  • Depressed brainstem reflexes, e.g., patient’s pupils do not respond properly to light.
  • Limbs are unresponsive except for reflex movements.
  • Patients do not respond to pain, other than reflex movements.
  • Uneven breathing.

A coma doesn’t typically last more than several weeks, and can be caused by a variety of things, including brain injury, stroke, brain tumor, intoxication, or an underlying illness like diabetes or infection. A coma is a medical emergency, and rapid action is necessary to preserve life and brain function. Although many patients gradually recover from the effects of a coma, those who remain in a coma for more than a few weeks sometimes transition to a persistent vegetative state or brain death.

Minimal consciousness

A patient who exhibits clear but slight or variable awareness is classified as being in a minimally conscious state, even if they sometimes have the ability to communicate or respond to requests. A person may enter a minimally conscious state after sustaining brain damage or being in a coma or vegetative state. Patients sometimes go back and forth between the vegetative state and minimally conscious state for years after the original brain damage.

People in a minimally conscious state may do things that indicate some awareness of self and of their environment, such as making eye contact. As a result, doctors can diagnose minimal consciousness only after they observe patients on more than one occasion for an extended period and find signs of awareness in people whose consciousness is severely impaired.

Imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) are done to check for disorders that may be causing minimal consciousness, especially those that can be treated. If the diagnosis is not definitive, doctors may do other imaging tests— positron emission tomography (PET) or single-photon emission computed tomography (SPECT) to determine how well the brain is functioning.

Vegetative state

When a person is awake but is showing no signs of awareness, they are considered to be in a vegetative state. Although a patient in a vegetative state might open their eyes, wake up and go to sleep at regular intervals, and have basic reflexes (such as reacting when they’re surprised by a loud noise), they don’t show any meaningful responses like following an object with their eyes or responding to someone’s voice.

If a person remains in a vegetative state for an extended period of time, it may be either:

  • A continuing vegetative state lasting longer than four weeks.
  • A permanent vegetative state lasting more than six months and caused by a non-traumatic brain injury, or more than 12 months if caused by a traumatic brain injury.

When a person is diagnosed as being in a permanent vegetative state, recovery is not impossible, but extremely unlikely.

Brain death

A person who has sustained brain death (also referred to as brain stem death) will not regain consciousness or be able to breathe without support. Because they no longer have any brain function, they can only be kept alive if they are put on an artificial life support machine. Those who are brain dead are also considered legally dead.

A medical professional will perform tests based on sound and legally accepted medical guidelines in order to diagnose brain death. These tests commonly include a clinical examination and, in some situations, other tests may be necessary. Although an individual may exhibit spinal activity or reflexes, spinal reflexes are triggered by electrical impulses in the spinal column. These reflexes may occur even though brain death has occurred.

The legal team at Kansas City Accident Injury Attorneys obtained a three-million dollar settlement for a client who sustained a TBI, with decreased functioning in nine cognitive areas, when she was struck by a drunk driver. If your family has been affected by an auto accident that resulted in traumatic brain injury, Call Kansas City Injury Attorneys at our offices or submit our contact form to set up your free initial case evaluation today.