Coma

What is a coma?

Coma is a state of absolute and complete longer-term loss of consciousness, in which a person’s body does not respond to irritation from the external environment. The condition can be caused by an injury such as a very severe head injury or diseases such as infections or tumors or toxins that have entered the body.

Those affected are unable to think consciously and are not aware of their surroundings, but they retain basic life-sustaining functions such as breathing and circulation.

They may appear healthy and look like they are asleep, but they are unable to respond to irritation from people or things around them.

The profoundly unconscious person may make some movement such as opening his eyes or grimacing as a reaction to external irritation, but he cannot control or be aware of these movements.

Prolonged coma is often referred to as a persistent vegetative state. It can last for years, depending on the cause and clinical features.

In most cases, the coma is temporary, rarely lasting more than 2 to 4 weeks. After exiting the condition, the prognosis is varied. Many people can make a full recovery, some may need training – most commonly occupational and physical therapy – while others may only partially recover normal functions.

What are the symptoms?

The main symptom is loss of consciousness. Usually, those affected do not consciously respond to external irritation and appear as if they are in a deep sleep. Also, patients can make spontaneous body movements. Those affected may shake or may move their eyes. If the condition is severe and some basic functions may also be affected.

What are the causes?

• Head trauma

A state of absolute and complete loss of consciousness can be caused by a significant head injury such as car accident or fall.

• Hemorrhage in the brain or skull

Types of cranial hemorrhages:

– Intracerebral hemorrhage – bleeding occurs in the brain tissue;

– Epidural hemorrhage – bleeding is inside the skull but outside the dura mater;

– Subdural hemorrhage – the bleeding is in the skull and inside the meninges, but not in the brain tissue.

– Subarachnoid hemorrhage – bleeding in the space immediately adjacent to the brain tissue.

The causes of cranial hemorrhages are:

• Hypertension – high blood pressure;
• Cerebral aneurysm – a weak spot in the blood vessels of the brain;
• Arteriovenous malformation – a collection of abnormal or malformed blood vessels with a spherical shape .
• Tumor formations;

Treatment of coma

In order to carry out proper treatment it is important to first diagnose the underlying cause of the condition . Depending on how deep the loss of consciousness is, life-saving resuscitation procedures may be required.

Once the patient has been clinically stabilized and is no longer in immediate danger to life, therapy is initiated to correct the underlying cause of the condition.

In people in a prolonged coma or persistent vegetative state, the focus of treatment is on preventing infection due to artificial nutrition and keeping the patient stable.

Therefore, the sufferer must be fed properly to prevent lung infections such as pneumonia – the most common cause of death in such cases – and bedsores. Physiotherapy is sometimes used to prevent bone, joint and muscle deformities.