Handbook of Clinical Neurology Vol.90 Disorders of Consciousness.pdf

Foreword
It is entirely appropriate that a volume of the Handbook of Clinical Neurology should be devoted to disorders of
consciousness, and the present volume is an pendium that will be of interest to all practicing neu-
rologists as well as to others concerned with the care of patients with an altered level of consciousness. Neurol-
ogists frequently evaluate patients with these disorders and are often consulted by specialists in other fields to
guide management and prognostication in individual cases. There are many causes for a disturbance of conscious-
ness, and – regardless of their area of subspecialty interest – all neurologists should have some expertise in their
approach atose or encephalopathic patients. Reversible disorders must be distinguished from irreversible
ones, lesions requiring neurosurgical management distinguished from those that are managed medically, and
patients requiring immediate intervention distinguished from those in whom any intervention is less urgent.
In the past this depended on the acumen and skill of the clinician. Although these are still important, the techno-
logical advances that have occurred in neuroimaging have changed the approach to patients with an altered level
of consciousness. Indeed, recent developments in functional brain imaging may eventually affect our understand-
ing of the neurological substrate of consciousness. Furthermore, with the advances that have occurred in the
management of patients in the intensive care unit, ethical issues and the provision of palliative care have also
e important considerations.
In this context, we were delighted that Professors Bryan Young and Eelco Wijdicks agreed to serve as editors
of this volume, as they have had enormous experience and have written extensively on disorders of consciousness,
and we are grateful to them for all their efforts in seeing the book through to fruition. They assembled an outstand-
ing group of coauthors, to whom we are also gratef