A coma is a prolonged state of unconsciousness. During a coma, a person is unresponsive to his or her environment. It can be caused by a variety of problems such as traumatic head injury, stroke, brain tumor, drug or alcohol intoxication, or even an underlying illness, such as diabetes or an infection.The person is still alive, but the brain is functioning at its lowest stage of alertness. You can’t shake and wake up someone who is in a coma like you can someone who has just fallen asleep.
Causes of coma
Trauma: often causes by car accident or fall or acts of violence.
Swelling of brain(cerebral edema) :It can causes by lack of oxygen, electrolyte imbalance, or hormones.
Bleeding(Hemorrhage) : Bleeding in the layers of the brain may cause coma due to swelling and compression on the injured side of the brain.It canCauses by high blood pressure(hypertension),cereberal aneurysm,arteriovenous malformation (AVM) and tumors.
Type of bleeding in brain including
- Intracerebral hemorrhage:Bleeding within the brain tissue
- Epidural hemorrhage: bleeding inside the skull, but outside the covering of the brain (Dura).
- Subdural hemorrhage: bleeding inside the skull, and inside the dura, but not in the brain tissue itself.
- Subarachnoid hemorrhage: bleeding in the space immediately adjacent to the brain tissue.
Stroke : Reduced or interrupted blood supply to the brain (stroke), which may be caused by blocked arteries or a burst blood vessel, can result in a coma.
Diabetes : low blood sugar
Oxygen deprivation: It can causes by Heart arrhythmias Lung disease(asthma and pneumonia),low red blood cell count(Anemia) and it can also occur with drowning or choking.
Infection: such as meningitis or encephalitis cause swelling (inflammation) of the brain, spinal cord or the tissues that surround the brain that can also develop coma.
Toxins: Exposure to toxins, such as carbon monoxide or lead, can cause brain damage and a coma.
Type of coma
Anoxic brain injury
Persistent vegetative state
Symptoms of Coma
- Closed eyes and pupils not responding to light
- Limbs that do not respond except for reflex movements
- Breathing pattern show irregular
- Lack of response to painful stimuli, except for reflex movements
Diagnosis of Coma
Doctor examine the how they respond to pain, and their pupil size,patient’s Reflexions.
Blood test will help the diagnosis of causes of coma weather it’s infected nervous system or not.
Computerized tomography (CT) scan,Magnetic resonance imaging (MRI),Electroencephalography (EEG) detect the brain hemorrhage, tumors, strokes and other conditions. This test is often used to diagnose and determine the cause of a coma.
Glasgow Coma Scale(GCS)
The Glasgow Coma Scale (GCS) can be used to assess the severity of brain damage following a head injury.The GCS measures the following functions including Eye Opening (E),Verbal Response (V),Motor Response (M).
Treatments of Coma
A coma is a medical emergency.Doctors start the treatment depends on the underlying cause of the coma such as,Trauma, kidney failure, liver disease, diabetes, poisoning,etc. Doctors will first check the affected patient’s ABC Airway and help maintain Breathing (respiration) and Circulation.
- Medications: it will control seizures.
- Diabetic shock: Glucose may be required in the case of diabetic shock.
- Surgery:It may require to relieve the pressure on the brain due to swelling or to remove a tumor.