Coma: Causes, Symptoms, Diagnosis, Treatment and Complications

A coma is a prolonged condition of unconsciousness. It can be brought on by a variety of illnesses, including brain tumors, strokes, drug or alcohol addiction, and traumatic head traumas. A person may even go into a coma due to an infection or an underlying medical condition like diabetes.

A coma is a medical emergency. Quick action is needed to preserve brain function and human life. Medical personnel typically request a brain scan and a series of blood tests to try and identify the cause of the coma so that the appropriate course of treatment may begin.

A coma usually lasts no longer than a few weeks. Extended durations of unconsciousness have the potential to cause brain death, often known as a persistent vegetative state.

Causes Of Coma

Many different things might cause a coma. Here are a couple of such examples:

• Brain injuries: These are often caused by violent crimes or collisions with vehicles.
• Stroke: A stroke is characterized as a decreased or interrupted blood flow to the brain and can be brought on by blocked arteries or ruptured blood vessels.
• Tumors: Brain cancers or brainstem tumors can cause comas.
• Diabetes: Abnormally high or low blood sugar levels can cause a coma.
• Insufficient oxygen: When the brain doesn't get enough oxygen, people who have had a heart attack or have been saved from drowning can not wake up.
• Infections: The outcome of illnesses such as meningitis and encephalitis is an enlargement of the brain, spinal cord, or surrounding structures. Severe infections may result in brain damage or a coma.
• Seizures: A coma could develop from persistent seizures.
• Toxins: Exposure to toxins, such as lead or carbon monoxide, can cause brain damage and put a person in a coma.
• Drugs and alcohol: A coma may result from a drug or alcohol overdose.

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Symptoms Of Coma

Typical indications of a coma include:

• Closed eyes.
• Decreased brainstem reflexes
• Limb reactions are restricted to reflex motions only.
• Irregular breathing.

Diagnosis Of Coma

Medical personnel can only count on physical indications as well as knowledge from friends and family because coma patients are unable to speak. Prepare to provide information about the affected person, such as:

• Symptoms that come on before a coma, such as headaches or vomiting.
• Details regarding how the affected person lost consciousness, including whether it occurred fast or over time.
• Noticeable symptoms before losing consciousness.
• medical history, encompassing any previous ailments the patient may have experienced The patient's history of stroke or ministroke is covered here.
• Recent alterations to the individual's behavior or health
• The individual's use of drugs, including illicit narcotics, prescription and over-the-counter drugs, and unapproved pharmaceuticals.

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Bodily assessment

Most likely, the exam will include:

• Evaluating the affected person's pupil size, responsiveness to painful stimuli, and reflexes.
• Investigating breathing patterns to help identify the cause of the coma.
• Examining the skin for signs of bruises caused by trauma.
• While monitoring for arousal indicators such as movement, opening or closure of the eyes, or vocalizations, speak loudly or apply pressure to the nail bed or angle of the jaw.
• Testing reflexive eye movements to help establish the genesis of the coma and the location of brain injury.
• Injecting either cold or warm water into the ear canals of the afflicted individual and watching the responses in their eyes.

Lab Tests

Blood samples are typically taken to search for:

• Total blood count 
• Sugar and electrolytes. Sugar is also known as glucose.
• Thyroid, kidney, and liver functions
• Carbon monoxide poisoning.
• Overindulgence in alcohol or drugs.
• A lumbar puncture, sometimes called a spinal tap, is a diagnostic procedure used to search for signs of diseases of the nervous system. During a spinal tap, a medical practitioner inserts a needle into the spinal canal to extract a small amount of fluid for analysis.

Brain Imaging

Imaging studies are useful in identifying brain damage sites. Possible tests include:

• CT scan: This produces a detailed image of the brain by taking a series of X-rays. Brain hemorrhage, tumors, strokes, and other diseases can all be seen with a CT scan. This test is frequently used to identify the origin of a coma and make a diagnosis.
• MRI: This produces an intricate image of the brain by utilizing strong radio waves and a magnetic field. Brain hemorrhage, brain tissue destroyed by an ischemic stroke, and other diseases can all be detected with an MRI scan. Deep brain areas including the brainstem can be examined with MRI scanning.
• Electroencephalogram (EEG): Brain electrical activity is measured using electrodes, which are small metal discs applied to the scalp. The electrodes are subjected to a small amount of electrical current to record brain electrical signals. If seizures are suspected as the cause of a coma, this test can determine it.

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Treatment Of Coma

A coma is a medical emergency. Initially, healthcare providers often evaluate the patient's airway and provide breathing and circulation support. Apart from providing supplementary supportive care, healthcare professionals may also assist with breathing and injecting drugs.

The etiology of the coma will dictate the course of treatment. To lessen the pressure that brain swelling places on the brain, a procedure or medication may be required. Emergency medical professionals may give glucose or antibiotics through an arm vein. Even before the results of a blood test are obtained, they can be given in cases of dangerously low blood sugar or brain infections.

Medical personnel will typically give medication to treat the coma if it is brought on by a drug overdose. If seizures are the reason for the coma, medication can treat them. Alternative treatment modalities may revolve around drugs or treatments meant to address underlying diseases like liver disease or diabetes.

A patient may be able to fully recover from a coma and return to their regular activities in certain circumstances. Usually, healing takes place gradually. Severe brain damage can leave a person permanently unable or unable to regain consciousness.

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Complications Of Coma

While many people gradually come out of a coma, other people may die or enter a persistent vegetative condition. Some people experience modest or severe disabilities after emerging from a coma.

When a patient is in a coma, problems such as leg blood clots, bedsores, and UTIs might occur.

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