For professionals

Introduction

In 1985, Minderhoud and Braakman described in this journal a number of patients who had ended up in a vegetative state after brain damage. In 1972, the Lancet proposed to call this state 'persistent vegetative state' (PVS), as the best description of this clinical picture. This term then became more and more popular in literature. In patients in a PVS, the higher brain functions have been impaired due to damage, while activities of the isolated brain stem can be observed, such as a sleep-wake rhythm (with opening the eyes), cough reflex, grinding teeth, smacking and compulsive crying. The patients breathe independently, but must be artificially fed through a tube through the nose or through a gastrostoma. There are no signs of purposeful action or of contact with the environment; The patient is 'awake but not aware'. A PVS can develop after cranial trauma, after massive bleeding in both hemispheres or after other acute brain damage, for example as a result of hypoxia or hypoglycemia.