Consciousness has remained a difficult problem for the scientists to explore its relationship to the brain activity. This is the first paper that presents the significance of focal areas of the cerebral cortex for consciousness. Objectives: To determine if consciousness is produced by the activity of the whole brain or one of its focal areas. Methods: We have performed a prospective cross-sectional study in eighty patients of acute ischemic stroke. The neurovascular territory of the middle cerebral artery (MCA) was sectioned into four similar areas. The association of any of these focal areas to consciousness was observed after their dysfunction with ischemic strokes. Results: Of the eighty patients, 57.5 % were males and 42.5 % were females. Mean age was 63 years ± 7 SD. The righthanded patients were 90 % (72) of the whole sample. Focal areas of the right MCA were generally less prone to consciousness disorder. Average statistics of the focal infarctions of the right MCA showed no tendency for consciousness disorder on the Glasgow coma scale (GCS) [Mean GCS of all focal areas;14.5, SD;0.71, 95 % CI;14.27 to 14.72, P= 0.0000004]. Altered consciousness with focal infarctions of the territory of left MCA was also less likely [Mean GCS of all focal areas;14.2, SD;1.01, 95 % CI;13.88 to 14.51, P= 0.0004]. Conclusion: Consciousness is not determined by the activity of a focal area of the cerebral cortex. Perhaps, we get our consciousness from the activity of “Neuronal Network of Coordination”.
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