Late recovery after traumatic, anoxic, or hemorrhagic long-lasting vegetative state.

Objectives: Late recovery of awareness in vegetative state (VS) is considered as an exceptional outcome, and has been reported prevalently after traumatic brain injury (TBI). The present pro- spective study aimed to verify frequency of late recovery (later than 1 year postonset in TBI and 3 months postonset in patients without TBI) of responsiveness and consciousness in traumatic and nontraumatic long-lasting (more than 6 months after onset) VS. Methods: Fifty inpatients with long-lasting VS (36% TBI, 36% hemorrhagic, and 28% anoxic) were enrolled and followed up for a mean of 25.7 months from onset (5 patients for more than 4 years). Level of responsiveness and functional disability were evaluated by means of validated scales (Coma Recovery Scale–Revised and Disability Rating Scale). Results: At the end of the study, 21 patients (42%) had died, 17 patients (34%) were in VS, and 2 patients with TBI (4%) had recovered responsiveness within 12 months postonset. The remaining 10 (20%) patients with TBI and patients without TBI showed late recovery of responsiveness; 6 of them (12%) further progressed to consciousness. Late recovery was significantly associated with younger age and was relatively more frequent in TBI. Functional abilities were severely im- paired in all patients. Conclusions: This clinical study demonstrates that late recovery of responsiveness and con- sciousness is not exceptional in patients with traumatic and nontraumatic VS, although with re- sidual severe disability