Coma: Causes, Symptoms, Diagnosis, Treatment, Duration and Care

It is a deep state of unconsciousness where the affected individual is alive but cannot react or respond to external stimuli.

Sometimes comatose patients are totally unaware of their states and surroundings; sometimes they are partially or fully conscious, but cannot communicate.

There is a lack of awareness, self-awareness, sleep-wake cycle, and voluntary movements in a coma patient.

But basic life-support functions, such as breathing and blood circulation , are preserved.

Causes of a coma

There can be a number of causes of coma. Some of them can be:

Shocking injuries and strokes

Any kind of strenuous mental injuries that may occur due to any act of violence or traffic accidents. However, they are not general reasons for coma.

Tumor

Any brain stem damaged by a tumor can trigger a coma.

Lack of oxygen

People who have been saved from any hearing damage or who have been saved from drowning may fall into a coma due to the loss of oxygen in the mind.

Seizures

The problem of consistent seizures can lead to the condition of coma.

Overdose

An overdose of medications, drugs, or alcohol can cause a coma.

Stroke

If there is an interruption or delay in the blood supply to the brain, it can lead to a stroke, it can block the arteries, or it can burst a blood vessel, leading to a coma.

Diabetes

People with diabetes experience a wide variation in blood sugar levels, which can be too low or hypoglycemic or it can be too high such as hyperglycemia, leading to coma.

Infections

Serious infections such as meningitis and encephalitis that cause inflammation in the brain, the tissues around the brain, or the spinal cord can lead to coma.

Contamination

Coming in contact with toxins, including lead or carbon monoxide, can damage the brain and lead to a coma.

When one of these things happens, it can slow the functioning of brain cells.

This can damage the parts of the brain that make someone conscious, and if those parts stop working, the person will be knocked unconscious.

Symptoms of a coma

The following are the general symptoms of coma:

  • Abnormal breathing
  • Closed eyes.
  • No reaction to painful incentives, apart from reflex actions.
  • Weak brain reflexes.
  • The pupils do not respond to stimuli.
  • No response in limb movement, in addition to normal reflex actions.

Diagnosis

To find out about the root cause of coma, doctors primarily perform a series of blood tests and imaging tests so that they can make a treatment plan.

Physical exam

During the physical checkup, the doctor will monitor the individual’s reflexes and movements, along with the size of the pupils and their response to painful stimuli.

They will also check the person’s breathing style to diagnose the reason for the coma.

Sometimes the person’s skin is also checked for any bruises or bruises due to trauma.

Doctors also check the individual’s level of consciousness by pressing the angle of the jaw or speaking loudly.

Next, look for any signs of arousal through movement, vocal noises, or eyes.

The doctor also notices the reflex movements of the eye. All of this helps to decide the main cause of the coma as well as the area where the damage has occurred in the brain.

Apart from this, the doctor can also spray warm or cold water on the ear canals of the affected person to observe the reactions of the eyes.

Brain scans

Using images and scans, the doctor can properly look at the area of ​​the brain where the damage has occurred.

The following checks can be made:

Magnetic resonance imaging

During the test, powerful magnets and radio waves are used to create a complete view of the brain.

Using this scan, a ruptured tissue in the brain can be detected, which could have occurred due to brain hemorrhages, an ischemic stroke, and other similar health conditions.

This scan aids in the analysis of deep brain structures and the stem.

CT scan test

During a CT scan, several X-rays are used to create a detailed photo of the brain, so that strokes, tumors, anything else can be seen.

This is done for the diagnosis and determination of the reason for the coma.

Electroencephalography

During this scan, electrical impulses in the brain can be measured after the doctor attaches small electrodes to the scalp.

This test is done to determine if the coma was caused by a seizure.

Treatment of a Coma

The initial emergency treatment of a patient in a coma focuses on stabilizing vital signs. This can quickly reverse the coma.

Since coma is a scientific emergency, first of all, the doctor checks the airway of the affected person to be able to offer assisted breathing.

In addition to respiratory support, blood transfusions and other supportive care may also be required.

The cause of the coma determines its treatment. If there is inflammation in the brain, anti-inflammatory medications may be required.

Medicine to control seizures will be prescribed if the condition is due to disease.

So treatment is different for coma if it is due to diabetes or any underlying health problems.

In most cases, the reason for a coma can be reversed and the person suffering from it can regain their consciousness.

However, if the condition is due to long-lasting disability or severe brain damage, or you are not regaining your consciousness by easily known methods, there may be a more serious problem.

This can slowly bring the person into a vegetative state or render their brain completely useless and what is known as a persistent vegetative state occurs.

After emerging from a coma, many people can make a full recovery; some require lifelong physical and occupational therapy, while others can regain basic functions.

Coma is not a disease

Coma is a symptom of an illness or a response to an event, such as a serious head injury, seizure, or metabolic problem.

Coma can appear slowly in conditions where there are previous medical or neurological problems, including secondary inflammation of the brain surrounding a pre-existing injury.

The outcome of the coma ranges from full recovery to death.

Whether a person recovers, and to what extent, depends on the cause of the coma and the type and extent of brain damage.

It is very important to know that the result may remain unknown for many months.

Most commas last longer than four weeks.

However, some people in a coma change to a persistent vegetative state, which can last for years, depending on the medical circumstances and the cause.

Persistent vegetative state

In a persistent vegetative state, the patient can breathe and may appear awake.

People in this state can open their eyes, but not recognize the things they see.

They can move parts of their body, but with little purpose. People in a coma or vegetative state can do some of these things:

  • Open the eyes.
  • Move in bed.
  • Grab the hand.
  • Laugh, cry or moan.

People in this state cannot speak or respond to commands.

Duration of a coma

It is difficult to predict how long someone will be in a coma. It usually does not last more than 2 to 4 weeks.

The persistent vegetative state, on the other hand, can last for years.

Some people may never wake up from a coma or come out of a coma with motor, intellectual, or emotional problems.

Some never get more than the basic answers. However, many regain full consciousness.

If the injury is severe, it can affect the person’s recovery.

A person does not wake up suddenly from a coma. It is a gradual process. Each person recovers at a different rate.

Special care for a patient in a coma

Usually, a person in a coma needs care in the intensive care unit of a hospital.

There, the person can get extra attention. They make sure the person gets fluids, nutrients, and any medications necessary to keep the body as healthy as possible.

They are sometimes given through a small plastic tube inserted into a vein or through a feeding tube that carries fluids and nutrients directly to the stomach.

Some comatose people cannot breathe on their own and need the help of a respirator, a machine that pumps air into the lungs through a tube placed in the windpipe.

Hospital staff also try to prevent pressure sores in someone who is in a coma.

Pressure ulcers are open sores on the body that come from lying in one place for a long time without moving at all.

Once the patient is out of harm’s way, although still in a coma, the medical staff will focus on keeping the patient healthy.

They will work to prevent illnesses, such as pneumonia, infection, or bed sores.

They will ensure that the patient receives the proper food and proper nutrition.

Physical therapists will move the patient’s arms and legs so that the muscles work properly.

This will help the patient to recover more quickly after waking up from the coma.

A person who remains in a coma for a long time, even years, will be able to do very little except breathe on his own.

Some of them can return to the normal life they had before they got sick.

Coming out of a coma, a person will likely be confused and will only respond slowly to what is happening.

It will take time for the person to start feeling better.

Whether someone is completely back to normal after being in a coma depends on what caused the coma and how badly the brain was injured.

Sometimes people who come out of commas are like before: they can remember what happened to them before the coma and they can do everything they used to do.

Other people may need therapy to relearn basic things like tying their shoes, eating with a fork or spoon, or learning to walk again.

They may even have trouble remembering things and talking.

However, over time and with the help of therapists, many people who have been in a coma can make great progress.

They may not be exactly the way they were before the coma, but they can do a lot and enjoy life with their family and friends.