Editing Coma (section)

===Imaging and testing===
Imaging encompasses [[CT scan|computed tomography]] (CAT or CT) scan of the brain, or [[MRI]] for example, and is performed to identify specific causes of the coma, such as [[hemorrhage]] in the brain or [[herniation]] of the brain structures.<ref name="Haupt Coma and cerebral imaging">{{cite journal |last1=Haupt |first1=Walter F |last2=Hansen |first2=Hans Christian |last3=Janzen |first3=Rudolf W C |last4=Firsching |first4=Raimund |last5=Galldiks |first5=Norbert |title=Coma and cerebral imaging |journal=SpringerPlus |date=December 2015 |volume=4 |issue=1 |page=180 |doi=10.1186/s40064-015-0869-y |pmc=4424227 |pmid=25984436 |doi-access=free }}</ref> Special tests such as an [[EEG]] can also show a lot about the activity level of the cortex such as semantic processing,<ref name="Daltrozzo01">{{cite journal |last1=Daltrozzo |first1=Jerôme |last2=Wioland |first2=Norma |last3=Mutschler |first3=Veronique |last4=Lutun |first4=Philippe |last5=Calon |first5=Bartholomeus |last6=Meyer |first6=Alain |last7=Pottecher |first7=Thierry |last8=Lang |first8=Simone |last9=Jaeger |first9=Albert |last10=Kotchoubey |first10=Boris |title=Cortical Information Processing in Coma |journal=Cognitive and Behavioral Neurology |date=March 2009 |volume=22 |issue=1 |pages=53–62 |doi=10.1097/WNN.0b013e318192ccc8 |pmid=19372771 }}</ref> presence of [[seizures]], and are important available tools not only for the assessment of the cortical activity but also for predicting the likelihood of the patient's awakening.<ref name="Daltrozzo02">{{cite journal |last1=Daltrozzo |first1=J. |last2=Wioland |first2=N. |last3=Mutschler |first3=V. |last4=Kotchoubey |first4=B. |title=Predicting coma and other low responsive patients outcome using event-related brain potentials: A meta-analysis |journal=Clinical Neurophysiology |date=March 2007 |volume=118 |issue=3 |pages=606–614 |doi=10.1016/j.clinph.2006.11.019 |pmid=17208048 }}</ref> The autonomous responses such as the [[skin conductance response]] may also provide further insight on the patient's emotional processing.<ref name="Daltrozzo03">{{cite journal |last1=Daltrozzo |first1=Jérôme |last2=Wioland |first2=Norma |last3=Mutschler |first3=Véronique |last4=Lutun |first4=Philippe |last5=Calon |first5=Bartholomeus |last6=Meyer |first6=Alain |last7=Jaeger |first7=Albert |last8=Pottecher |first8=Thierry |last9=Kotchoubey |first9=Boris |title=Emotional electrodermal response in coma and other low-responsive patients |journal=Neuroscience Letters |date=May 2010 |volume=475 |issue=1 |pages=44–47 |doi=10.1016/j.neulet.2010.03.043 |pmid=20346390 }}</ref>

In the treatment of traumatic brain injury (TBI), there are 4 examination methods that have proved useful: skull x-ray, angiography, computed tomography (CT), and magnetic resonance imaging (MRI).<ref>{{Cite journal |last1=Lee |first1=Bruce |last2=Newberg |first2=Andrew |date=April 2005 |title=Neuroimaging in Traumatic Brain Imaging |journal=NeuroRx |volume=2 |issue=2 |pages=372–383 |doi=10.1602/neurorx.2.2.372 |pmc=1064998 |pmid=15897957}}</ref> The skull x-ray can detect linear fractures, impression fractures (expression fractures) and burst fractures.<ref>{{cite journal |last1=Nakahara |first1=Kuniaki |last2=Shimizu |first2=Satoru |last3=Utsuki |first3=Satoshi |last4=Oka |first4=Hidehiro |last5=Kitahara |first5=Takao |last6=Kan |first6=Shinichi |last7=Fujii |first7=Kiyotaka |title=Linear Fractures Occult on Skull Radiographs: A Pitfall at Radiological Screening for Mild Head Injury |journal=Journal of Trauma: Injury, Infection & Critical Care |date=January 2011 |volume=70 |issue=1 |pages=180–182 |doi=10.1097/TA.0b013e3181d76737 |pmid=20495486 }}</ref> Angiography is used on rare occasions for TBIs i.e. when there is suspicion of an aneurysm, carotid sinus fistula, traumatic vascular occlusion, and vascular dissection.<ref>{{cite journal |last1=Korkmazer |first1=Bora |last2=Kocak |first2=Burak |last3=Tureci |first3=Ercan |last4=Islak |first4=Civan |last5=Kocer |first5=Naci |last6=Kizilkilic |first6=Osman |title=Endovascular treatment of carotid cavernous sinus fistula: A systematic review |journal=World Journal of Radiology |date=2013 |volume=5 |issue=4 |pages=143–155 |doi=10.4329/wjr.v5.i4.143 |pmc=3647206 |pmid=23671750 |doi-access=free }}</ref> A CT can detect changes in density between the brain tissue and hemorrhages like subdural and intracerebral hemorrhages. MRIs are not the first choice in emergencies because of the long scanning times and because fractures cannot be detected as well as CT. MRIs are used for the imaging of soft tissues and lesions in the posterior fossa which cannot be found with the use of CT.<ref name="Haupt Coma and cerebral imaging"/>