Abstract

A neurosurgical view of consciousness is presented. It is biased by our need to deal with coma. The concept of primary or neurosurgical consciousness is discussed, and the anatomy, physiology, pathology and clinical features described in a simple a way. It is suggested that the dynamic interaction between the reticular activating system and the cerebral cortex is the anatomic and physiologic basis for primary consciousness. It is emphasised that this in no way diminishes the role of the cortex in either primary or higher-order consciousness. In essence, a presentation is made of the neurosurgical view of cortex-brainstem inter- relationships, and the importance of this interrelationship to consciousness