Found Down

Abstract

AbstractConsciousness is believed to arise from two inter-related brain functional states: wakefulness, reflecting an individual’s level of arousal and response to external stimuli, and awareness, representing the content of one’s conscious experience and the ability to interact with the external environment. Disruption to either or both states may result in a patient being “found down.” The inability to take an accurate medical history, the limitations of physical examination in the obtunded patient, and the need to rapidly make treatment decisions position imaging centrally within the evaluation of most of these patients. Radiologists should be prepared to help decide on an appropriate imaging strategy, suggest a limited differential diagnosis as to root causes for the patient’s condition, identify problems that mandate emergent medical or surgical intervention and, in some cases, assist in defining short- and long-term prognosis.