Coma : Causes-Symptoms-Diagnosis-Treatment
What is a Coma?
A coma could be a deep state of unconsciousness. a private in a very coma is alive however unable to maneuver or reply to his or her environment. Coma could occur as a complication of an underlying illness, or as a result of injuries, akin to brain injury.
A coma seldom lasts quite a pair of to four weeks. The end result for coma depends on the cause, severity, and website of the damage. folks may start out in a coma with physical, intellectual, and psychological problems. Some people may stay in a coma for years or maybe decades. For those people, the foremost common reason behind death is infection, akin to pneumonia.Someone who is in a very coma is unconscious and has least brain activity. They're alive however can't be woken up and show no signs of awareness.
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The person' eyes are closed and they'll seem to be unresponsive to their environment. They won't usually reply to sound or pain, or be able to communicate or move voluntarily, and basic reflexes, such as coughing and swallowing, will be greatly reduced.
they will be able to breathe on their own, though some folks need a machine to assist them breathe.
Over time, the person could begin to regain awareness and become aware. Some folks can rouse for many weeks, whereas others may get in a vegetative or minimally conscious state. browse more concerning disorders of consciousness.
Medical terms
- Coma is a prolonged state of mind that may be caused by a range of issues — traumatic head injury, stroke, brain tumor, drug or alcohol intoxication, or maybe an underlying illness, admire polygenic disease or an infection. Coma may be a medical emergency. Swift action is required to preserve life and brain function. Doctors usually order a series of blood tests and a brain scan to see what inflicts the coma in order that correct treatment can begin. A coma rarely lasts longer than many weeks. Those that are unconscious for an extended time might transition to a persistent vegetative state or brain death.
- A coma is a state of deep unconsciousness from which a person cannot be awakened. It can result from high fever, severe head injury or other causes. The medical term for this condition is "coma vigil." This means that the patient's eyes are open and he's breathing irregularly but is not awake. In the case of brain damage this state can last six weeks or more. With brain injury resulting in oxygen deprivation the coma may last only a few days before death occurs.
Prevention According to the Coma Recovery Association there are three steps you can take to reduce your risk of developing a coma First practice safe sleep habits Second eat a healthy diet Third get regular exercise By incorporating these steps into your everyday routine you can greatly reduce your risk of developing a coma and improving your overall health and wellness.
Types of Coma
Types of coma can include:
Toxic-metabolic encephalopathy. This is an associate degree acute condition of brain pathology with symptoms of confusion and/or delirium. The condition is typically reversible. The causes of toxic-metabolic brain disorder are varied. They embody general illness, infection, organ failure, and different conditions.
Persistent vegetative state. This is a state of severe unconsciousness. The person is unaware of their surroundings and incapable of voluntary movement. With a persistent vegetative state, somebody could reach wakefulness however with no higher brain function. With persistent vegetative state, there's breathing, circulation, and sleep-wake cycles.
Medically induced: This type of temporary coma, or deep state of unconsciousness, is employed to guard the brain from swelling when AN injury. The patient receives a controlled dose of an anesthetic that causes a lack of feeling or awareness. Doctors then closely watch the person’s vitals. This happens solely in hospital medical care units.
Symptoms Coma
The signs and symptoms of a coma commonly include:
Closed eyes
Depressed brainstem reflexes, such as pupils not responding to light
No responses of limbs, except for reflex movements
No response to painful stimuli, except for reflex movements
Irregular breathing
When to see a doctor
A coma could be a medical emergency. ask for immediate medical aid for the person in an exceedingly coma.
Causes Coma
- Comas are caused by injury to the brain, particularly if there’s bilateral damage to the cerebral mantle (which means that damage on each side), or damage to the latticed activating system. The reticular activating system controls arousal and awareness of the cerebral cortex. injury here may end up from several potential factors.Anoxic brain injury.
- This can be a brain condition caused by a total lack of gas to the brain. Lack of oxygen for a number of minutes causes death to brain tissues. hypoxia brain injury could result from attack (cardiac arrest), head injury or trauma, drowning, drug overdose, or poisoning. TraumaAnoxic brain injury. This can be a brain condition caused by a total lack of oxygen to the brain. Lack of oxygen for a few minutes causes cell death to brain tissues. hypoxia brain injury may result from heart attack (cardiac arrest), head injury or trauma, drowning, drug overdose, or poisoning. Trauma Head injuries can cause the brain to swell and/or bleed. Once the brain swells as a result of trauma, the fluid pushes up against the skull. The swelling may eventually cause the brain to cut down on the brain stem, which may injure the RAS (Reticular Activating System) -- a locality of the brain that's answerable for arousal and awareness. Swelling of brain tissue can occur even while not in distress. generally a scarcity of oxygen, solution imbalance, or hormones can cause swelling.
- Hurt within the layers of the brain may cause coma thanks to swelling and compression on the abraded aspect of the brain. This compression causes the brain to shift, inflicting injury to the neural structure and therefore the RAS (mentioned above). High blood pressure, cerebral aneurysms, and tumors are non-traumatic causes of hurt within the brain. Stroke once there's no blood flow to a serious part of the brain stem or loss of blood attended with swelling, coma can occur. In individuals with diabetes, coma can occur when blood sugar levels keep terribly high. That's a condition called hyperglycemia. Hypoglycemia, or blood sugar that's too low, also can cause a coma. This kind of coma is sometimes reversible once the glucose is corrected. However, prolonged symptoms can cause permanent brain injury and protracted coma. Gas deprivation gas is crucial for brain function. Cardiopulmonary arrest causes an unexpected cutoff of blood flow and oxygen to the brain, referred to as drive or anoxia. Once resuscitation (CPR), survivors of cardiac arrest are typically in comas. Gas deprivation also can occur with drowning or choking.
- Infection Infections of the central nervous system, similar to infectious disease or encephalitis, can also cause coma. Toxins Substances that are ordinarily found in the body can accumulate to deadly levels if the body fails to lose them correctly. As an example, ammonia thanks to liver disease, greenhouse emission from a severe respiratory disorder attack, or organic compounds from nephropathy can accumulate to toxic levels within the body. medicine and alcohol in massive quantities also can disrupt somatic cell functioning in the brain. Seizures one seizure seldom produces coma. however continuous seizures -- referred to as epilepsy -- can. Continual seizures can stop the brain from getting sick in between seizures. This can cause prolonged state of mind and coma. Head injuries can cause the brain to swell and/or bleed. Once the brain swells as a result of trauma, the fluid pushes up against the skull. The swelling may eventually cause the brain to cut down on the brain stem, which may injure the RAS (Reticular Activating System) -- a locality of the brain that's answerable for arousal and awareness.
- Swelling of brain tissue can occur even while not in distress. generally a scarcity of oxygen, solution imbalance, or hormones can cause swelling. Hurt within the layers of the brain may cause coma thanks to swelling and compression on the abraded aspect of the brain. This compression causes the brain to shift, inflicting injury to the neural structure and therefore the RAS (mentioned above). High blood pressure, cerebral aneurysms, and tumors are non-traumatic causes of hurt within the brain. Stroke once there's no blood flow to a serious part of the brain stem or loss of blood attended with swelling, coma can occur. In individuals with diabetes, coma can occur when blood sugar levels keep terribly high. That's a condition called hyperglycemia. Hypoglycemia, or blood sugar that's too low, also can cause a coma. This kind of coma is sometimes reversible once the glucose is corrected. However, prolonged symptoms can cause permanent brain injury and protracted coma.
- Gas deprivation gas is crucial for brain function. Cardiopulmonary arrest causes an unexpected cutoff of blood flow and oxygen to the brain, referred to as drive or anoxia. Once resuscitation (CPR), survivors of cardiac arrest are typically in comas. Gas deprivation also can occur with drowning or choking. Infection Infections of the central nervous system, similar to infectious disease or encephalitis, can also cause coma. Toxins Substances that are ordinarily found within the body can accumulate to deadly levels if the body fails to lose them correctly. As an example, ammonia thanks to liver disease, greenhouse emission from a severe respiratory disorder attack, or organic compounds from nephropathy can accumulate to deadly levels within the body. medicine and alcohol in massive quantities also can disrupt somatic cell functioning in the brain. Seizures one seizure seldom produces coma. however continuous seizures -- referred to as epilepsy -- can. Continual seizures can stop the brain from getting sick in between seizures. This can cause prolonged state of mind and coma.
Many types of problems can cause a coma. Some examples are:
Traumatic brain injuries. These are often caused by traffic collisions or acts of violence.
Stroke. Reduced or interrupted blood supply to the brain (stroke), can result from blocked arteries or a burst blood vessel.
Tumors. Tumors in the brain or brainstem can cause a coma.
Diabetes. Blood sugar levels that become too high (hyperglycemia) or too low (hypoglycemia) can cause a coma.
Lack of oxygen. People who have been rescued from drowning or those who have been resuscitated after a heart attack might not awaken due to lack of oxygen to the brain.
Infections. Infections such as encephalitis and meningitis cause swelling of the brain, spinal cord or the tissues that surround the brain. Severe cases of these infections can result in brain damage or a coma.
Seizures. Ongoing seizures can lead to a coma.
Toxins. Exposure to toxins, such as carbon monoxide or lead, can cause brain damage and a coma.
Drugs and alcohol. Overdosing on drugs or alcohol can result in a coma.
Complications Coma
Although many folks step by step endure a coma, alternatives enter a vegetative state or die. Some those who recover from a coma find themselves with major or minor disabilities. Complications will develop throughout a coma, together with pressure sores, tract infections, blood clots within the legs and other problems.
Can a person recover from a coma?
Yes, a person can recover from a coma . People who have been in a coma can become conscious again. The length of the coma depends on what caused it, how long it lasted and the damage to the brain.
How long does a coma last?
A coma is a state in which a person is unresponsive unaware of themselves and their surroundings and unable to voluntarily move While there are many causes of coma generally they fall into two categories: traumatic or nontraumatic Traumatic Coma A traumatic (or acquired) coma occurs after head injury or shock This type of coma may result from brain damage due to a blood clot or hemorrhage physical trauma such as a blow to the head being thrown from a moving vehicle or being involved in an accident with another vehicle It can also occur as the result of aneurysms - weak spots on blood vessels that can burst and cause bleeding within.
How do you get out of a coma?
There are two kinds of comas One is known as a "medical coma," which is a state of unconsciousness caused by illness injury or some medical condition The other type is known as an unconsciousness caused by trauma to the head or brain and doesn't have a medical cause In either case comas are diagnosed based on the patient's ability to show reactions to stimuli such as pain and eye movements and speech Generally doctors use tests like CT scans and MRI imaging studies to find out the cause of the coma.
What are the chances of coming out of a coma?
What are the chances of coming out of a coma? In a study published in the journal “Critical Care Medicine,” researchers examined nearly 1,500 cases of individuals who had been admitted to hospitals after they collapsed due to a lack of oxygen The investigators found that 15 percent – or 211 patients – had regained consciousness and most were reported to have gone back to living normal lives.
How long is recovery after a coma?
According to the National Institutes of Health coma is a state of unconsciousness in which a person can't be awakened; doesn't respond to stimuli; and doesn't have sleep-wake cycles normal body temperature or breathing Recovery from coma depends on the extent of the brain damage and how long the person has been in a coma A person may remain in a vegetative state for years or may die within days after entering a vegetative state.
How long can you be in a coma before brain damage?
A coma is a state of unconsciousness which may be caused by injury poisoning or disease It’s a serious medical condition and one which can result in permanent brain damage if not treated immediately In general the longer an individual remains in a coma the more severe the brain damage will be If there are no other injuries or diseases present it is possible to recover after being in a coma for 3 days without any lasting damage to the brain However if there have been other head injuries or if the cause of the coma was due to poisoning or disease such as meningitis or encephalitis (inflammation of the lining of the brain) recovery.
How do doctors wake someone up from a coma?
Doctors can wake a person from coma by treating their underlying cause and by giving them medications to help reverse the effects of sedation Once the patient has been stabilized doctors treat the underlying cause such as infection or bleeding in the brain If the cause cannot be treated or corrected patients may need to remain in a state of sedation for long periods of time or until a cure is found.
Can people in a coma hear you?
Completely unconscious people in a coma have no awareness of their surroundings or their own existence People in this state may appear to be awake but have no voluntary control over their eyes muscles or reflexes Most people who are comatose are unable to hear because they are not responsive to sounds Although rare some people in comas can respond to sound by producing related movements that appear to be purposeful.
Diagnosis Coma
When somebody has an associate degree impairment of consciousness, a health care specialist can raise friends and family about any events or symptoms that semiconductors diode up to the coma. They’ll also enkindle details about recent changes within the person’s life, medical history, and drug use. medications of concern embrace prescribed drugs and over-the-counter drugs, furthermore as recreational drugs.Because folks in a very coma can't categorize themselves, doctors should trust physical clues and data provided by families and friends. Be ready to produce information about the affected person, including:
Events leading up to the coma, such as vomiting or headaches
Details about how the affected person lost consciousness, including whether it occurred suddenly or over time
Noticeable signs or symptoms before losing consciousness
The affected person's medical history, including other conditions he or she may have had in the past, such as a stroke or transient ischemic attacks
Recent changes in the affected person's health or behavior
The affected person's drug use, including prescription and over-the-counter medications as well as unapproved medications and illicit recreational drugs
Physical exam
The exam is likely to include:
Checking the affected person's movements and reflexes, response to painful stimuli, and pupil size
Observing breathing patterns to help diagnose the cause of the coma
Checking the skin for signs of bruises due to trauma
Speaking loudly or pressing on the angle of the jaw or nail bed while watching for signs of arousal, such as vocal noises, eyes opening or movement
Testing reflexive eye movements to help determine the cause of the coma and the location of brain damage
Squirting cold or warm into the affected person's ear canals and observing eye reactions
Laboratory tests
Blood samples will be taken to check for:
Electrolytes, glucose, thyroid, kidney and liver function
Carbon monoxide poisoning
Drug or alcohol overdose
A spinal puncture (lumbar puncture) will check for signs of infections within the nervous system. Throughout a spinal tap, a doctor or specialist inserts a needle into the canal and collects a little quantity of fluid for analysis.
Brain scans
Imaging tests help doctors pinpoint areas of brain injury. Tests might include:
CT scan. This uses a series of X-rays to form a close image of the brain. A CT scan will show a brain hemorrhage, tumors, strokes and different conditions. This takes a look at is commonly accustomed to diagnose and verify the explanation for a coma.
MRI. This uses powerful radio waves and magnets to form a close read of the brain. AN imaging will observe brain tissue broken by an anemia stroke, brain hemorrhages and alternative conditions. MRI scans are significantly helpful for examining the brain stem and deep brain structures.
Electroencephalography (EEG). This measures the electrical activity within the brain through tiny electrodes hooked up to the scalp. Doctors send a coffee electrical current through the electrodes that record the brain' electrical impulses. This take a look at will verify if seizures could be the reason behind a coma.
Treatment Coma
A coma could be a medical emergency. Doctors can 1st check the affected person' airway Associate in Nursing to facilitate respiratory and circulation. Doctors may offer breathing assistance, endovenous medications and different appurtenant care. Treatment varies, betting on the explanation for the coma. A procedure or medications to alleviate pressure on the brain because of brain swelling can be needed. Emergency personnel might administer aldohexose or antibiotics intravenously, even before biopsy results return, just in case of diabetic shock or an infection touching the brain. If the coma is the result of drug overdose, doctors will give medications to treat the condition. If the coma is because of seizures, doctors will use medications to regulate seizures. different treatments may concentrate on medications or therapies to deal with Associate in Nursing underlying disease, comparable to polygenic disorder or liver disease. Generally the explanations for a coma are often utterly reversed, and also the affected person will regain traditional function. Recovery usually happens gradually. an individual with severe brain harm might need permanent disabilities or ne'er regain consciousness.A coma is sometimes a significant medical emergency. aid professionals will begin by making certain the immediate survival of the individual. they'll secure their breathing and circulation to maximize the number of chemical elements that reach the brain. As a 2021 reviewTrusted supply explains, any treatment can then rely upon the underlying explanation for the coma.
The treatment options may include administering:
glucose, even before the results of blood tests are available, in case the person is in diabetic shock or has a brain infection
a drug called naloxone (Narcan), if severe intoxication has likely caused the coma
vitamin B1, if the person has alcohol use disorder, which can lead to a deficiency of this vitamin
In all cases, doctors ought to additionally aim to stay the individual’s pressure level at an honest level and maintain their respiratory system by protecting their airways. In some cases, doctors might have to alleviate pressure among the individual’s os by exhausting the surplus CSF or prescribing medication that reduces brain swelling, love diuretic drug and hypertonic saline.
Preparing for your appointment
A coma is an associated emergency medical condition. If you're with someone who develops signs and symptoms of a coma, decide 911 or your native emergency range immediately. After you make the hospital, hospital room workers can request the maximum amount of data as doable from family and friends regarding what happened to the affected person before the coma. you would possibly be asked the subsequent queries whereas riding within the ambulance:
Did the coma start abruptly or gradually?
Were there problems with vision, dizziness or weakness beforehand?
Does the affected person have a history of diabetes, seizures or strokes?
Did you notice changes in the affected person's health in the time leading up to the coma, such as a fever or worsening headache?
Did you notice changes in the affected person's ability to function in the time leading up to the coma, such as frequent falls or confusion?
Did the affected person use prescription or nonprescription drugs?
