Persons with brain injury transition through the period of unconsciousness and subsequent stages of recovery at a slower or faster rate, largely depending on the severity of injury.
use a common object in a normal way such as brushing hair with a brush, using a straw to drink, holding a phone to the ear, etc. communicate by speaking words or by indicating yes or no by head nods or gestures and/or. 
follow simple instructions from others such as, “Open your eyes,” “Squeeze my hand,” “Say your name,” etc. When people start to regain consciousness, they may: What happens after coma and vegetative state? Management of other medical issues such as fever, seizures, etc. 
Management of infections such as pneumonia or urinary tract infections. Special equipment that may include a wheelchair or special bedding to help with proper posture and decrease muscle tightness. Management of muscle tone (excessive tightness of muscles). Management of breathing such as suctioning of secretions this may include care for a tracheostomy tube. Assistance with bowel and bladder relief using catheter and/or diapers. Special bedding to help prevent pressure sores. Turning in bed to prevent pressure sores. Persons in coma or vegetative state require extensive care that may include: May react to a loud sound with a startle. May briefly move eyes toward persons or objects. May cry or smile or make other facial expressions without apparent cause. May moan or make other sounds especially when tight muscles are stretched. Return of a sleep-wake cycle with periods of eye opening and eye closing. No speech or other forms of communication. 
Recovery can stop at any one of these phases. As people recover from severe brain injury, they usually pass through various phases of recovery. The state of complete unconsciousness with some eye opening and periods of wakefulness and sleep is called the vegetative state. The state of complete unconsciousness with no eye opening is called coma. The diagnosis given these people depends on whether their eyes are always closed or whether they have periods when their eyes are open. Some persons who survive have a period of time of complete unconsciousness with no awareness of themselves or the world around them. Twenty to 40% of persons with injuries this severe do not survive. The most severe injuries cause profound disturbance of consciousness. Some injuries are mild and may cause relatively minor changes in consciousness such as brief confusion or disorientation. Brain injury can cause a wide range of disturbances of consciousness. Consciousness refers to awareness of the self and the environment. Severe brain injury causes a change in consciousness.
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