Description

The Coma is a state of prolonged loss of consciousness. You can have a variety of causes, including traumatic brain injury, stroke, brain tumor, or drug or alcohol intoxication. A comma can even be caused by an underlying disease, such as diabetes or an infection.

Coma is a medical emergency. The rapid action is needed to preserve life and brain function. Health professionals usually order a series of blood tests and a brain scan to try to find out what is the cause of the coma so that treatment can begin.

In a state of coma doesn't usually last more than several weeks. The people who are unconscious for a time longer possible to transition to a perennial vegetative state, known as a persistent vegetative state or brain death.

Symptoms

The symptoms of a coma usually include:

  • Eyes closed.
  • Depression of brain stem reflexes, such as pupils not responding to light.
  • There are No responses of the limbs, except for reflex movements.
  • There is No response to painful stimuli, except for reflex movements.
  • Irregular Breathing.

When to see a doctor

The coma is a medical emergency. Seek medical attention immediately to the person in a state of coma.

Causes

Many types of problems that can cause a coma. Some examples are:

  • Traumatic injuries of the brain. These are often caused by traffic accidents or acts of violence.
  • Stroke. Reduction or interruption of the blood supply to the brain, known as a stroke, may be the result of the blockage of the 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 or too low can cause a coma.
  • The lack of oxygen. The people who have been rescued from drowning, or revived after a heart attack might not wake up due to the lack of oxygen to the brain.
  • Infections. Infections such as encephalitis and meningitis cause inflammation of the brain, spinal cord, or in the tissues that surround the brain. Severe cases of these infections can result in brain damage or coma.
  • Seizures. Course of seizures may lead to a state of coma.
  • Toxins. Exposure to toxins, such as carbon monoxide, lead, can cause brain damage, and coma.
  • Drugs and alcohol. An overdose of drugs or alcohol can result in a coma.

Risk factors

Risk factors for the comma are:

  • Severe head injury.
  • Stroke.
  • Bleeding in the brain, known as one of intracranial bleeding.
  • Tumor in the brain.
  • Diabetes blood sugar too high or too low.
  • Health conditions such as hypothyroidism or very low sodium in the blood.
  • Low blood pressure, serious heart failure.
  • Epilepsy, including seizure that lasts more than five minutes or happen one after another without the person regaining consciousness.
  • Serious infections, such as sepsis, meningitis or encephalitis.
  • Near drowning, which decreases the amount of oxygen in the brain.
  • The excessive use of alcohol, or use illegal drugs.
  • Exposure to carbon monoxide, lead, or other toxins.

The risk of coma increases with age. This is especially true if older adults:

  • You have a brain disease or another illness such as diabetes, high blood pressure, or kidney disease.
  • Take multiple medications, which can lead to drug interactions or of an accidental overdose.

Complications

Although many people will gradually recover from a coma, others enter into a persistent vegetative state, or death. Some people who recover from a comma at the end with a greater or lesser disability.

During a state of coma, decubitus ulcers, urinary tract infections, blood clots in the legs and other problems may develop.

Diagnosis

Because people in comas can't express themselves, health professionals must rely on the physical clues and information provided by family members and friends. Be prepared to provide information about the affected person, including:

  • The events that led to the coma, such as vomiting or headaches.
  • The details about how the affected person loses consciousness, even if it occurred quickly or over time.
  • Obvious symptoms before losing consciousness.
  • The medical history, including other conditions the person may have had in the past. This includes if the person has had a stroke or mini-stroke.
  • The recent changes in the health of the person or behavior.
  • The person of the use of drugs, including prescription and non-prescription drugs that are not approved, and illicit drugs.

Physical examination

The exam is likely to include:

  • The checking of the affected person's movements and reflexes, response to painful stimuli, and the size of the pupil.
  • The observation of the breathing patterns to help diagnose the cause of the coma.
  • Checking your skin for signs of hematomas due to trauma.
  • To speak in a loud voice, or by pressing the angle of the jaw, or of the bed of the nail, while the observation of signs of arousal, such as vocal noises, the eyes of opening or movement.
  • Tests of reflexes, eye movements to help determine the cause of the coma, and the location of the brain damage.
  • Jets of cold or warm water on the affected person's ear canals and seeing the eyes of the reactions.

Laboratory tests

Blood samples are usually taken to check:

  • Complete blood count.
  • Electrolytes and sugar. The sugar is also called glucose.
  • The thyroid, kidneys, and liver functions.
  • Carbon monoxide poisoning.
  • Drug or alcohol overdose.

A lumbar puncture, also known as a lumbar puncture, you can check if there are signs of infection in the nervous system. During a lumbar puncture, a health care professional inserts a needle into the spinal canal and you get a small amount of fluid for analysis.

The brain scans

Imaging tests help to identify the areas of brain injury. Tests may include:

  • Computed tomography. This uses a series of X-rays to create a detailed picture of the brain. A ct scan can show bleeding in the brain, tumors, stroke and other conditions. This test is often used to diagnose and determine the cause of a state of coma.
  • The magnetic resonance imaging. This uses powerful radio waves and a magnetic field to create a detailed view of the brain. An mri scan can detect bleeding in the brain, the brain tissue is damaged by an ischemic stroke and other conditions. Magnetic resonance imaging are particularly useful for examining the brain stem and deep structures of the brain.
  • Electroencephalogram (EEG). This measures the electrical activity within the brain through small metal disks called electrodes attached to the scalp. A low electrical current travels through the electrodes, we recorded the electrical impulses of the brain. This test can determine if the attacks could be the cause of a state of coma.

Treatment

The coma is a medical emergency. Health professionals usually check first the person affected of the respiratory tract and help to maintain breathing and circulation. A person in a coma may need breathing assistance, medications through a vein and other supportive care.

The treatment depends on the cause of the coma. A procedure or medication to relieve pressure on the brain due to inflammation of the brain may be necessary. Emergency personnel can give glucose or antibiotics through a vein in the arm. These medicines can be given even before the blood of the results of the test of return in the cases of very low blood sugar or an infection that affects the brain.

If the coma is the result of a medication or an overdose of illegal drugs, health professionals are often given medications to treat the condition. If the coma is due to the attacks, medications can control seizures. Other treatments may focus on the drugs or therapies to treat an underlying disease, such as diabetes or liver disease.

Sometimes, the cause of a coma you can be completely reversed, and the affected person to recover the function. Recovery usually occurs gradually. A person with severe brain damage can have permanent disabilities or never regain consciousness.

Preparing for your appointment

The comma is an emergency medical condition. If you are with a person who has symptoms of a coma, call 911 or emergency medical help immediately.

When you arrive at the hospital, emergency room, the staff will need as much information as possible of your family and friends about what happened to the person before the comma. You may be asked the following questions while riding in the ambulance:

  • Did the comma start abruptly or gradually?
  • There were problems with vision, dizziness, or weakness ahead?
  • It makes the affected person has a history of diabetes, seizures or strokes?
  • Does the affected person to talk to about the changes in health in the time leading up to the comma, such as fever or headache is getting worse?
  • Have you noticed changes in the affected person's ability to function in the time leading up to the comma, such as frequent falls or confusion?
  • Does the person use of prescription or non-prescription medications?
Symptoms and treatment of Coma