Basic science and clinical neurology provide insights into the understanding of how alertness and awareness arise in the brain. Impairment of alertness implies dysfunction of the ascending reticular activating system (ARAS). Awareness, the content of consciousness, requires integrated function of the cerebral cortex and thalamus. Impairments in various aspects of awareness (including perception, apperception, declarative memory, working memory, cognition, and planned activity) result from structural or metabolic disturbances of these regions. The impairment of consciousness can be classified into a number of syndromes, such as neglect syndromes, delirium, vegetative state, minimally conscious state, stupor and coma, and brain death. A neurological examination is required to assess the level of consciousness, assessment of cranial nerve functions, motor responses, and respirations. Powerful new neurobiological technologies in basic neuroscience hold promise for the detailed neurophysiology of various components of consciousness, especially processing of and combining of information and the initiation of responses.
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