Given that there is a broad

differential diagnosis for eventrelated neuropsychiatric disturbances, this last point is especially important: proper use of the term PTE necessitates establishing with confidence that the encephalopathy represents neurotrauma-induced brain dysfunction and is not simply post-traumatic in that it occurs after trauma. Taxonomically, PTE is superordinate to five linearly hierarchical subordinate stages (from lowest to highest): post-traumatic coma, post-traumatic delirium (confusion Inhibitors,research,lifescience,medical al state), post- traumatic amnesia, and post-traumatic dysexecutive syndrome (Table V). This organization is anchored to the most clinically salient cognitive feature of each Inhibitors,research,lifescience,medical stage of PTE, and describes the concurrent, and/or persistent,

noncognitive neuropsychiatric symptoms of PTE at each stage as well. Table V. The stages of post-traumatic encephalopathy. Using PTE as a guide to the description, evaluation, and treatment of TBI-induced neuropsychiatric disturbances obviates the conceptual and semantic debate in this literature,6-8,22,34,48,50,67-71 much of which derives from attempts to use any other single terms as a global descriptor of the clinical phenomenology Inhibitors,research,lifescience,medical of the post-injury period. The present Inhibitors,research,lifescience,medical framework acknowledges that the phenomena described by terms like “post-traumatic amnesia,” “posttraumatic confusional state,” and “post-traumatic delirium” may (and often do) occur after TBI and that each is a potentially important focus of clinical concern, study, and treatment. However, it, encompasses all of these phenomena within PTE and regards each as only one of several stages through which persons with TBI transition during the post-injury period. It would be conceptually correct, to describe see more patients whose early post-traumatic neuropsychiatric disturbances

become chronic Inhibitors,research,lifescience,medical problems as remaining in PTE (and the specific stage at which recovery reached its plateau). It is possible that there is merit to doing so, but the current practice is to describe such patients using more specific clinical descriptors. For example, Bay 11-7085 wakefulness without, awareness is usually described as a “vegetative state”71 and wakefulness with minimal awareness is described as a “minimally conscious state.”70,72 It, also is common to describe the clinical presentation of patients who fail to emerge from post-traumatic delirium or post-traumatic amnesia using the term “posttraumatic dementia” – that is, a syndrome of persistent and acquired impairments in multiple cognitive domains.