Litchi News reports: Reporter Gao Zhipeng

　　How far are we from “brain injury”? Traffic accidents and workplace incidents can both result in head trauma; sudden hypertensive crises and cerebral infarctions, too, can easily lead to intracranial hemorrhage, causing severe disturbances of consciousness. According to statistics, globally, patients in a “vegetative state” account for roughly one in 100,000 to six in 100,000, making it a relatively common condition. Out of ethical considerations and respect for patients’ needs, the international medical community has now revised the terminology for such conditions, replacing the previously common term “vegetative state” with “unresponsive wakefulness syndrome.”

　　On December 20, Nanjing Zijin Hospital hosted the “2020 Zijin Forum and Summit on Brain Injury and Advanced Neurological Rehabilitation” at the Jiangning Convention and Exhibition Center. Renowned domestic experts shared their latest research findings in the field of brain injury. What are the specific classifications of the “vegetative state”? Which populations should be particularly vigilant about potential risks? And how can we best “care for” our brains? This summit provided clear answers to these questions.

　　She is fully conscious, yet she cannot tell the world, “I am still alive.”

　　“She is not only alive; she is fully conscious. She can hear every conversation, recognize each visitor, and know every decision made on her behalf. Yet she cannot move a single muscle to tell the world: ‘I’m still here—I’m not dead yet!’”

　　At the outset of his presentation, Professor Di Haibo of the International Institute for the Science of Plant States and Consciousness at Hangzhou Normal University shared this deeply troubling “story.” Although the case is drawn from a film clip, Professor Di told Litchi News that further differentiation among the specific categories of “disorders of consciousness” is essential, enabling clinicians to tailor treatment to each patient’s condition.

　　“‘Disorders of consciousness’ can broadly be categorized into three types: the first comprises patients who are entirely unconscious—commonly referred to as ‘vegetative state’ patients; the second includes patients who are fully conscious but unable to interact with the world in any way, requiring family members and healthcare professionals to engage with them continuously and offer encouragement; and the third consists of patients who retain some degree of awareness. Former racing champion Michael Schumacher, who fell into an unexpected coma, falls into this latter category, and over the years his family has been actively pursuing efforts to help him regain consciousness.”

　　Due to the lack of clear, specific classifications for “disorders of consciousness,” and given the considerable difficulty and complexity involved in determining whether a person remains conscious, many family members caring for patients often feel completely at a loss, unsure where to begin—and may even resort to caregiving practices that are entirely inappropriate.

　　Professor Di Haibo noted that, until now, the assessment and classification of “disorders of consciousness” have been primarily conducted by the Coma Science Group at the University of Liège in Belgium. He hopes to facilitate the implementation of this research within China and, concurrently, to establish “awakening‑promoting wards” based on a categorized management framework, providing patients with long-term care through a systematic management protocol.

　　Traumatic and non‑traumatic injuries: Be vigilant about the various “head risks” in daily life.

　　The primary causes of “disorders of consciousness” stem from brain injury, according to Gao Zhiqiang, deputy director of medical affairs and chief physician at Nanjing Zijin Hospital. He told Litchi News that trauma is one of the leading causes of brain injury.

　　“The first category of traumatic injuries is traffic accidents—such as those involving electric scooters and other vehicles. These often involve high speeds, and riders rarely wear protective gear, making them highly susceptible to traffic-related trauma. Another common cause is workplace accidents on construction sites: failure to follow proper safety procedures or being struck by falling construction materials can result in brain injury.”

　　In addition to traumatic injury, conditions such as hypertension and cerebral infarction can also predispose individuals to intracerebral hemorrhage, which may lead to brain damage and result in severe cognitive impairment.

　　“Some people can experience a cerebral hemorrhage even while asleep, or it may occur during the day—while at work or at social gatherings—and most of these patients have a history of hypertension,” added President Gao Zhiqiang. Based on an analysis of the ages of patients seen, the proportion of hypertensive cerebral hemorrhage cases among those aged 40 to 50 is even higher than that among individuals over 65. “Older adults tend to be more attentive to their health and regularly visit hospitals for check-ups, whereas younger people often assume they are ‘very healthy,’ which actually makes them more prone to problems.”

　　Many households lack the specialized equipment needed to measure blood pressure. So how can one determine whether a patient has suffered a cerebral hemorrhage? Director Gao Zhiqiang told Lizhi News, “When a cerebral hemorrhage occurs, the patient typically experiences headache and vomiting. Family members may also notice that, along with these symptoms, the patient’s responsiveness may become sluggish or even lapse into unconsciousness.” As for the “golden time” for bringing a patient to the hospital, Director Gao Zhiqiang emphasized that “the sooner, the better,” ideally seeking treatment within six hours.

　　Can staying up late and overworking yourself lead to “sudden death”? Doctors say this isn’t just a baseless rumor.

　　As the year draws to a close, office workers are racing to meet their targets and nail their year-end KPIs, while students are cramming for their final exams. Pulling all-nighters has become the norm in young people’s daily routines.

　　So, can chronic sleep deprivation damage the brain—and even lead to sudden death?

　　Dean Gao Zhiqiang stated that the secretion of neurotransmitters by brain cells also requires periodic regulation. Prolonged sleep deprivation clearly disrupts the physiological rhythms established during human growth and development, leaving the brain in a state of excessive fatigue, which can lead to neurotransmitter dysfunction and trigger cardiac arrhythmias. Meanwhile, staying up late often elevates blood pressure, and there are numerous cases of cerebral hemorrhage attributable to this habit.

　　“Although many people believe that staying up late at night can be made up for by sleeping in during the day, the external sounds and light that stimulate the brain’s neural circuits elicit quite different responses,” added President Gao Zhiqiang. “The most fundamental factor is melatonin: when exposed to light, its secretion increases. Only with an appropriate level of melatonin can one sleep well at night. Disrupting this natural rhythm throws hormonal balance out of whack, making one more susceptible to a wide range of health problems.”

　　The “Love Accompanies Childhood” charitable aid project has been launched to support children from impoverished families.

　　The proportion of pediatric patients with brain injuries is also significant. According to statistics from Nanjing Zijin Hospital, over the past three years, the hospital has admitted nearly 300 young patients in the rehabilitation phase following brain or spinal cord injuries; the primary conditions include traumatic brain injury, spinal cord injury, and neurological dysfunction resulting from other etiologies.

　　Following the summit, Nanjing Zijin Hospital simultaneously launched the “Love Accompanies Childhood” charitable assistance program. Over the next year, the hospital will allocate a special fund of RMB 200,000 to support underprivileged children and adolescents under the age of 16 receiving treatment at Zijin Hospital, covering a specified portion of their medical expenses based on their actual treatment needs to ensure they can continue receiving care.