When the patient begins to wake up, the thought processes (cognitive functions) begin to become discernible and can be assessed. Patients usually wake up very gradually. Progress is made in slow steps that take time. Low-intensity controlled stimuli, such as speech, touch, sound, or visual stimuli, are more beneficial than longer stimuli, which confuse the patient.
Each patient has their own pace, going through these stages at a rate that depends on the severity of the injury. This progress may take days, weeks, months, or even years. There may also be no progress and the patient could remain with their eyes open, but without specific reactions to environmental stimuli (“vegetative state”). The longer this lasts, the less likely the patient is to recover.
As the patient continues to show progress towards recovery, some permanent problems (residual damage) may be identified. The type and severity of these problems vary depending on the extent of the brain damage.