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Disorders of Consciousness Management Center

Unconscious Patient Management Center


Disorders of Consciousness (DoC)  Program.

Disorder of consciousness (DOC) is a state of prolonged altered consciousness, which can be categorized into coma, vegetative state, or minimally conscious state based on neurobehavioral function. Loss of consciousness or unconsciousness is the most devastating consequence of brain damage. With improvement in intensive and critical care we are able to save many lives in the initial stages but some patients still remain in a vegetative state. If interventions such as comprehensive and multidisciplinary stem cell therapy and neurorehabilitation are initiated early, under physician supervision, they can significantly alter a patient's course and improve neurological and functional outcomes.


Vegetative State


A vegetative state occurs when the cerebrum (the part of the brain that controls thought and behavior) no longer functions, but the hypothalamus and brain stem (the parts of the brain that control vital functions, such as sleep cycles, body temperature, breathing, blood pressure, heart rate, and consciousness) continue to function. Thus, people open their eyes and appear awake but otherwise do not respond to stimulation in any meaningful way.

Brain Death


Brain death is the permanent loss of brain activity. As a result, people cannot breathe or maintain other vital functions on their own, and they permanently lose all awareness and capacity for thought.Artificial means can temporarily maintain breathing and the heart’s beating even when all brain activity stops. But eventually, even with help from artificial means, all the body's organs stop working. Nothing can keep the heart beating indefinitely once brain death occurs.


Disorders of consciousness include coma (cannot be aroused, eye remain closed), vegetative state (can appear to be awake, but unable to purposefully interact) and minimally conscious state (minimal but definite awareness). Locked-in syndrome is not a disorder of consciousness but can look like one because of paralysis of limbs and facial muscles that causes an inability to speak and/or appearance of being unable to react.


Most patients who survive brain injury regain consciousness, but they may also have impaired consciousness. This can range from decreased awareness of their surroundings to a persistent vegetative state and even brain death.Trauma, reduced blood supply or oxygen to the brain, and poisoning are leading causes for disorders of consciousness.

Disease Phases

After trauma, the patient may be in a coma for several weeks. If the patient survives, he or she may be in a vegetative or brain-dead state. The duration of vegetative state or brain death varies, ranging from a few days to several years, and in some cases may be permanent. Emergence from a vegetative state or brain death due to trauma is more likely than from other causes, especially as time passes. Several cases have been reported of patients emerging from a vegetative state more than one year after traumatic brain injury, but not due to other causes. Patients who have emerged from the vegetative state show signs of being able to interact and communicate.

Rehabilitation Management

The Physical Medicine and Rehabilitation (PM&R) Physician oversees medical management which focuses on improving consciousness as well as preventing and managing complications from prolonged immobility. They provide general health care that includes keeping skin healthy, stretching arms and legs, and bowel and bladder management. Patients may develop spasticity, pneumonia, or blood clots. Amantadine is a medication that may improve arousal if given during the weeks after traumatic brain injury.  Other medications that stimulate patients, stem cell transplant therapy, and physical means are also used.


Trauma-related disorders have better outcomes among patients with disorders of consciousness than non-trauma causes. Rehabilitation during the first 6 months after traumatic brain injury may increase the chances of improving outcomes in people who are minimally conscious. Patients recovering at earlier time periods generally have better outcomes than those recovering at later times. Omgeneum have expertise in predicting functional prognosis.


Anoxic Brain Damage


Anoxic brain damage (ABD) is harm to the brain due to a lack of oxygen. Brain cells without enough oxygen will start to die after about 4 minutes.


  • Shock and heart problems, like a heart attack

  • Lung disease

  • A lack of oxygen in the air, which may happen at high altitudes

  • Being around certain poisons, such as carbon monoxide

  • An event that is stopping breathing, such as drowning, choking, or suffocation


Initial Treatment
Treatment will depend on the cause. 

Choices are:

  • Oxygen to raise the amount of oxygen in the blood

  • Medicine to help get enough blood with oxygen to the brain

  • Cooling the brain to limit problems


Recovery can take months or years. It depends on how long a person went without oxygen. 

  • These therapies may be needed:

  • Physical therapy to retrain motor skills, such as walking

  • Occupational therapy to relearn daily skills, such as dressing and going to the bathroom

  • Speech therapy to work on language problems

  • Counseling for behavior and emotional issues



Day 1-

  • Pick up from the Airport to the Hospital.

  • Medical Examinations 

  • Admission procedure.

  • Clinical examination & Lab test 

  • Supportive Therapy.

Day 2-

  • Stem cell Procedure

  • Supportive therapies

  • Physiotherapy

Day 3-

  • Supportive Therapy

  • Physiotherapy

  • Discharging formalities

  • Drop back to the Airport

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