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PubMedDate not supplied

[Simulation of attempted homicide by dog bite in unconscious state].

It is reported on the unusual event of dog scavenging in an unconscious and intoxicated (alcohol) person. Due to the particular circumstances a case of attempted homicide was primarily suspected. Peculiarities of the case were a small dog (dachshund) as the responsible cause and the survival of the injured woman. Intensive and partly deep wounds due to scavenging were found on both shoulders/upper arms in nearly symmetrical order. Vomit from the dog could be assigned to the unconscious person by DNA typing. The typical morphological features of dog bites and injuries due to scavenging, respectively, and the possible motivation of the animal are discussed.

Aged↗
PubMed1975

Spastic eyelids. Failure of levator inhibition in unconscious states.

Three patients exhibited tonic uninhibited lid elevation in unconscious states. In the two cases adequately studied at autopsy, the lesions were too large for precise localization but suggest that damage to the pons (and probably midbrain as well) can interfere with normal lid relaxation in coma and sleep.

Adult↗
PubMed1983

Posttraumatic syringomyelia with paroxysmal episodes of unconsciousness.

A 41-year-old man survived 23 years with quadriplegia following a C-5 fracture dislocation. During the last four months of his life he had paroxysmal episodes of unconsciousness. Necropsy disclosed a posttraumatic syrinx. The cyst extended caudally to the midlumbar region and rostrally into the midline of the medulla without communication into the fourth ventricle. Central apnea due to expansion of the cyst in the medullary respiratory centers is postulated as the possible cause of his paroxysmal episodes of unresponsiveness.

Adolescent↗
PubMed1993

How does a serial, integrated and very limited stream of consciousness emerge from a nervous system that is mostly unconscious, distributed, parallel and of enormous capacity?

Much of the nervous system can be viewed as a massively parallel, distributed system of highly specialized but unconscious processors. Conscious experience on the other hand is traditionally viewed as a serial stream that integrates different sources of information but is limited to only one internally consistent content at any given moment. Global Workspace theory suggests that conscious experience emerges from a nervous system in which multiple input processors compete for access to a broadcasting capability; the winning processor can disseminate its information globally throughout the brain. Global workspace architectures have been widely employed in computer systems to integrate separate modules when they must work together to solve a novel problem or to control a coherent new response. The theory articulates a series of increasingly complex models, able to account for more and more evidence about conscious functioning, from perceptual consciousness to conscious problem-solving, voluntary control of action, and directed attention. Global Workspace theory is consistent with, but not reducible to, other theories of limited-capacity mechanisms. Global workspace architectures must show competition for input to a neural global workspace and global distribution of its output. Brain structures that are demonstrably required for normal conscious experience can carry out these two functions. The theory makes testable predictions, especially for newly emerging, high-speed brain imaging technology.

Consciousness↗
PubMed1989

A computer model for unconscious spread of anxiety-linked inhibition in cognitive networks.

Unconscious inhibitory processes, triggered by a potential anxiety reaction, are reviewed in the context of an emerging rapprochement between psychodynamic and cognitive approaches in experimental psychology. Conditions underlying spread of inhibitory action to other cognitive networks are first explored in three tachistoscopic experiments utilizing words posthypnotically tied to a potential anxiety, pleasure, or neutral reaction. Response times of subjects, instructed to ignore those words while naming pictures or solving anagrams as quickly as possible, reveal a highly differentiated pattern of circumstances governing likelihood of inhibitory spread from anxiety-linked words to target stimuli. Next a computer model is constructed to simulate cognitive processes from onset of display to eventual response, and the model is then tested for its fit to the empirical data. Finally, an illustrative study shows that a subset of computer-generated predictions for spread of inhibitory action is verifiable experimentally.

Adult↗
PubMed2001

Empathy and the unconscious.

The author examines the complex relationship between the concepts of empathy and unconscious, including exploration of topical, structural, and dynamic aspects; and the risk of oversimplification of empathy is discussed. Two clinical examples are then presented to demonstrate some of the complex factors that may contribute to or hinder the development and utilization of empathy by the analyst, many of which lie outside the analyst's conscious awareness.

Awareness↗
PubMed1996

Memory for unconsciously perceived events: evidence from anesthetized patients.

Studies investigating memory for events during anesthesia show a confusing pattern of positive and negative results. To establish whether there are any consistent patterns of findings across studies, we conducted a meta-analysis of the data from 2517 patients in 44 studies. The meta-analysis included two measures of the effects of positive suggestions on postoperative recovery: (a) the duration of postoperative hospitalization and (b) the amount of morphine administered via patient-controlled anesthesia, as well as two measures of memory for specific information presented during anesthesia: (c) direct tests and (d) indirect tests. The meta-analysis indicated that positive suggestions presented during anesthesia have little or no effect on postoperative recovery. On the other hand, the meta-analysis showed that specific information is remembered following surgery, as long as testing is not delayed longer than 36 h. Studies of memory for events during anesthesia provide a useful avenue for exploring unconscious cognition.

Anesthesia, General↗
PubMed1992

Blunt basal head trauma: aspects of unconsciousness.

Two cases of street violence directed to the skull base level and transverse to the cervical axis are described. No skeletal damage. The violence resulted in the so-called "traumatic subarachnoid haemorrhage", an often used, unspecified forensic "diagnosis"; it was here revealed to be due to rupture of the wall of the posterior inferior cerebellar artery (p.i.c.a). However, this was only one of the possible explanations for the acute symptoms of unconsciousness (concussion) and almost immediate death. The careful examination of these two cases and of a series of control cases revealed that at the trauma, stress and strain may have occurred to arterial branches serving as feeding perforant vessels to the medulla oblongata; in these cases they were coursing directly from the p.i.c.a. region.--The type of direct impact has often been regarded as mild! However, its location suboccipitally as in these cases can become dangerous. The resulting direct or indirect deficit of brain stem functions are discussed in these cases as well as "concussion-related symptoms" resulting after other types of head and neck injury.

Adult↗
PubMed1996

Drugs in blood samples from unconscious drug addicts after the intake of an overdose.

This investigation includes whole blood samples from 53 drug addicts found unconscious in the Copenhagen area with evidence of a heroin overdose. Heroin/morphine was detected in 85% of the patients and other opioids in 11%. One or more benzodiazepines, most often diazepam, were detected in 75% of the patients. A blood alcohol concentration higher than 1.00 mg/g was detected in 57% of the patients. Methadone was detected in seven patients, ketobemidone in four, amphetamine in five and cocaine in one. This investigation showed widespread multi-drug abuse and heroin/morphine alone was detected in only one patient. As indicators of heroin intake, 6-mono-acetylmorphine (MAM) and morphine were detected in this investigation.

Adult↗
PubMed1996

Unconsciously induced song recall: the process of unintentional rather than so-called spontaneous evocations of music.

This paper has presented the basis for a reformulation of the traditional psychoanalytic usage of the term spontaneous evocations. Illustrated with a supervisory example, I have argued for a return to Freud's original use of the word unintentional or to equivalent synonyms. The process whereby such unexpected music evocations appear in consciousness has been termed "unconsciously induced song recall." The role of serendipity in this theoretical reformulation will be addressed separately (see Díaz de Chumaceiro, 1995; Díaz de Chumaceiro and Yáber, 1994). Like dreams, music evocations can be subjected to analysis and interpretation, if when recalled by indirect or direct induction in treatment they are mentioned to the therapist. This basic principle of induced recall can be generalized to evocations of the art world at large.

Humans↗
PubMed1996

[Examination of the unconscious patient].

The unconscious patient presents an challenging emergency in the intensive care unit. Patient evaluation and treatment must occur simultaneously. After checking vital signs, deciding about cardiopulmonary resuscitation or intubation, an intravenous line must be established, blood samples collected and glucose and thiamine should be given. The physical and neurological examination should be performed in a efficient way and must consider the following eight points: best reaction to loud commands, best motor reaction to noxious stimuli, respiratory pattern, size and reactions of pupils, eye movements, corneal and blink reflex, meningismus, muscle tone and deep tendon reflexes. With this approach it is possible to formulate a working diagnosis, and the appropriate diagnostic steps can be performed.

Coma↗
PubMed1992

Effects of thyrotropin releasing hormone and its analogues on unconsciousness following head injury in mice.

We examined the effects of thyrotropin releasing hormone (TRH) and its analogues (DN-1417: gamma-butyrolactone-gamma-carbonyl-histidyl-prolinamide citrate; MK-771: L-pyro-2-aminoadipyl-histidyl-thiazolidine-4-carboxamide; TSII-37: H-Lys-Gln-His-Pro-Gly-Ser-OH) on arousal in head injured mice, an animal model of unconsciousness. TRH, DN-1417, MK-771 and TSII-37 were injected 10 min before the head injury. TRH, DN-1417 and MK-771 caused dose-dependent decreases in the time required for recovery of the righting reflex time and in the time from the head injury to the onset of spontaneous movement. TSII-37 had no effect, when compared with the control group. In terms of the minimum effective dose, TRH and DN-1417 were of similar potency, but MK-771 was about 30-fold stronger than TRH. Measurement of the cross-reactivities of these TRH analogues by radiolabeled receptor assay suggest that the structure-binding relationship is proportional to the structure-activity relationship.

Animals↗
PubMed1995

Diagnosis of unsuspected facial fractures on routine head computerized tomographic scans in the unconscious multiply injured patient.

PURPOSE: This article assessed the value of routine head computerized axial tomographic (CT) scans for diagnosis of unsuspected facial fractures and its clinical implications in the multiply injured patient who is intubated, unconscious, or sedated at the time of initial assessment and requires a head CT scan to assess for brain injury. METHODS: At a level I trauma center from June 1, 1992 to June 1, 1993 all intubated blunt trauma patients who required routine CT scan evaluation at initial assessment were studied prospectively. Routine scanning started at the foramen magnum and included the maxilla. Patients who died within the first 24 hours were excluded. RESULTS: The study population included 116 patients (85 male, 21 female) aged 12 to 85 years (mean, 28 years) with injury severity scores ranging from 1 to 50 (mean, 23). The mechanism of injury was: motor vehicle accidents (n = 74), motorcycling (n = 5), pedestrians accidents (n = 13), falls (n = 10), bicycling (n = 5), assaults (n = 8), and boating accident (n = 1). There were 19 suspected facial fractures; 18 required surgical repair. There were 27 unsuspected facial fractures; 13 required surgical care. Three suspected fractures were ruled out. CONCLUSION: Routine head CT scans to assess for brain injury in the multiply injured patient are also very useful in the diagnosis of unsuspected facial fractures, almost half of which will require surgical intervention.

Abbreviated Injury Scale↗
PubMed1981

Natural history of global and critical brain ischaemia. Part II: EEG and neurological signs in patients remaining unconscious after cardiopulmonary resuscitation.

Of 125 patients who had no detectable cortical activity (DCA) on the electroencephalograph (EEG) immediately upon resuscitation from circulatory arrest of primary cardiovascular aetiology, 88 remained unconscious; these patients had their EEG and neurological status serially investigated until they died. Immediately upon re-establishment of circulation all cerebral functions could be absent; the brain death (irreversible loss of functions) was then signified by the appearance of poikilothermia, diabetes insipidus and reflex extension of the upper limb. Most often, some cranial nerve reflexes were present; the EEG configurations and related neurological signs then appeared in a sequence which resembled orderly postischaemic recovery: A phase without DCA was at first characterized by an exclusive presence of cranial nerve reflexes and then by the appearance of decerebrate posturing this phase was followed by another phase of intermittent cortical activity (ICA) with decorticate and stereotypic motor responses and a phase of continuous cortical activity (CCA) accompanied by stereotypic reactivity. These phases were most often incomplete due to failure of recovery of some cranial nerve reflexes or were abnormal due to the appearance of intermittent spikes and sharp waves. Progressive recovery could stagnate at any step and the cerebral functions be lost abruptly or gradually in reverse order of recovery. The decay was invariably due to cardiovascular or pulmonary complications. Brain autopsy revealed extensive neuronal loss and intravital autolytic changes in patients who had fulfilled clinical criteria of brain death for more than 72 h, but the histopathology showed no relationship to other clinical findings during the postischaemic course.

Adolescent↗
PubMedDate not supplied

Outcome of children with prolonged unconsciousness and vegetative states.

The outcomes of 60 children unconscious for 90 days or longer following acquired brain injury are reported. Eight children who died had remained in persistent vegetative states. As expected, most neurologic improvement occurred within the first year after injury, although some delayed improvements were observed. Outcomes were strongly correlated with causes of brain injury. Better cognitive and motor function was observed with nonanoxic injuries. No child in this report with anoxic brain injury regained functional cognitive or motor skills, although 3 became socially responsive. The remarkable contrast with adults following acquired brain injury is the significantly longer survival of children. The only children who died had remained in persistent vegetative states.

Adolescent↗
PubMed2006

Unconsciousness.

This paper reviews a theory on the physiological conditions of consciousness. The theory consists of four hypotheses: (1) The occurrence of states of consciousness depends on the formation of higher-order representations that represent the internal state of the brain itself. (2) Higher-order representations are instantiated by the spatio-temporal activity pattern of large-scale neuronal assemblies. (3) The N-methyl-D-aspartate (NMDA) synapse plays a crucial role in the generation of conscious states by implementing the binding mechanism that the brain uses to produce large-scale assemblies. (4) The activation state of the NMDA receptor determines the rate at which representational structures can be built up. Unconsciousness or altered states of consciousness occur if, and only if, NMDA-dependent binding processes are inhibited.

Anesthetics↗
PubMed2006

Unconscious modulation of the conscious experience of voluntary control.

How does the brain generate our experience of being in control over our actions and their effects? Here, we argue that the perception of events as self-caused emerges from a comparison between anticipated and actual action-effects: if the representation of an event that follows an action is activated before the action, the event is experienced as caused by one's own action, whereas in the case of a mismatch it will be attributed to an external cause rather than to the self. In a subliminal priming paradigm we show that participants overestimated how much control they had over objectively uncontrollable stimuli, which appeared after free- or forced-choice actions, when a masked prime activated a representation of the stimuli immediately before each action. This prime-induced control-illusion was independent from whether primes were consciously perceived. Results indicate that the conscious experience of control is modulated by unconscious anticipations of action-effects.

Adult↗
PubMed2005

Unconscious word-stem completion priming in a mirror-masking paradigm.

The aim of this study was to investigate unconscious priming by the use of a spatial mirror-masking paradigm. Words and nonwords with no under-length letters are mirrored at their horizontal axis. The results are figures of geometric-like forms that contain letters in their upper part. In the three experiments reported in this study, a priming procedure used such mirrored words and nonwords as primes. Participants were ignorant of the nature of the construction of the stimuli. Perceptual reports of the participants revealed that they did not realize that words were hidden in the primes. Nevertheless, they showed priming in all three experiments. Priming effects were replicated with prime-target SOAs of between 1 and 3 s. Functional dissociations were found between ignorant and informed participants. Informed groups showed perceptual and semantic priming, while ignorant groups showed only perceptual priming.

Female↗