Long-lasting coma

n this report, we describe the case of a patient who has remained in a comatose state for more than one year after a traumatic and hypoxic brain injury. This state, which we refer to as long-lasting coma (LLC), may be a disorder of consciousness with significantly different features from those of conventional coma, the vegeta- tive state, or brain death. On the basis of clinical, neu- rophysiological and neuroimaging data, we hypothe- size that a multilevel involvement of the ascending reticular activating system is required in LLC. This description may be useful for the identification of other patients suffering from this severe disorder of con- sciousness, which raises important ethical issues.