Proving cortical death after vascular coma: Evoked potentials, EEG and neuroimaging

Prognostication of coma outcome is a key factor for the management of critically ill patients. The self-fulfilling prophecy related to treatment limitation is likely to appear after neurological insults with tragic consequences in case of erroneous prognostication, especially if a bad outcome is expected (Murray et al., 1993). With this caveat in mind, it is important to consider that clinical judgment appears frequently more severe than the objective assessment 6 months after traumatic brain injury (Bonds et al., 2015) and could conduce to inappropriate early care withdrawal in anoxic coma (Elmer et al., 2016; Gobert et al., 2016).

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