Coma

2021-08-23 03:27 PM

Treatment varies depending on what is causing the coma, sometimes surgery is needed to relieve the pressure caused by brain edema.

Define

Coma diagnosisbook

Coma patient

A coma is a prolonged state of unconsciousness that can be caused by a variety of problems, a head injury, a stroke, a brain tumor, drug or alcohol intoxication, or even an underlying disease, such as diabetes, or infection.

Coma is a medical emergency. Rapid action is needed to preserve life and brain function. Doctors often run blood tests and CT scans of the brain to try to determine what's causing the coma so that the right treatment can be started.

A coma rarely lasts more than a few weeks. For those who are unconscious for longer, the transition can lead to a persistent vegetative state. Depending on the cause of the coma, people who are in a vegetative state for more than three years are very difficult to awaken.

Symptoms

Signs and symptoms of a coma usually include:

Close eyes.

Impaired brain stem reflexes, such as unresponsiveness to light.

There is no limb response except for reflexes.

There is no response to painful stimuli, except for reflexes.

Do not breathe often.

Coma is a medical emergency. Seek immediate medical attention.

Causes

Many problems can cause a coma. Some examples are:

Brain-damaged. Brain injury that results from traffic crashes, violent behavior is the most common cause of coma.

Stroke. Loss of blood flow to the brain followed by embolism or bleeding of a large part of the brain stem can lead to coma.

Diabetes. Blood sugar that is too high (hyperglycemia) or too low (hypoglycemia) can cause a coma.

Lack of oxygen. People who have been rescued from drowning or revived from cardiac arrest may not be able to wake up because of the lack of blood flow and oxygen to the brain.

Infection. Encephalitis and meningitis are infections that cause inflammation of the brain, spinal cord, or tissues surrounding the brain. Severe cases of either infection can lead to coma.

Epileptic. Seizures can lead to coma.

Toxic. Exposure to toxins, such as carbon monoxide or a drug overdose, can cause brain damage and coma.

Poisoned. Overdosing on drugs or drinking alcohol can lead to a coma.

Complications

Although many people gradually recover from a coma, others fall into a vegetative state or die.

Complications that can develop during coma include pressure pain, urinary tract infections, and pneumonia.

Tests and diagnostics

Because the comatose person cannot express himself, doctors must rely on physical clues and information provided by family and loved ones.

Be prepared to answer some questions about:

What happens leads to a coma?

Effects of medical history, including other diagnoses.

Recent changes in health or behavior of the affected person.

Affected people use drugs, including prescription and over-the-counter drugs as well as illegal, recreational drugs.

Clinical examination

Doctors will test reflexes, responses to painful stimuli. Cold or warm water in the ear can also get information. In people who are unconscious, these tests will cause different eye movement reflexes depending on what caused the unconsciousness.

Blood test

Complete blood count (CBC).

Electrolytes, glucose, and liver and kidney function.

Carbon monoxide.

Drug overdose.

A lumbar puncture can check for signs of infection. In a lumbar puncture, the doctor inserts a needle into the spinal canal and collects fluid for analysis. The whole procedure usually takes about 10 minutes.

Cranial scan

Imaging tests help doctors identify areas of brain injury. These may include:

CT scan. CT scans use X-rays connected to a computer to create detailed images of the brain. This is the best image for evaluating brain damage because it can show brain tissue or hemorrhage or emphysema. The brain scan takes only a few minutes.

MRI. Uses magnetic fields and radio waves to create images of the brain. The patient lies inside a cylindrical machine for 15 minutes to an hour. MRI is especially useful for examining the brain stem and deep brain structures. Sometimes dye is injected into a blood vessel during the procedure. The dyes can help distinguish damaged brain tissue from healthy tissue.

Electroencephalography (EEG). EEG electrical activity inside the brain. Small electrodes are attached to the scalp. The electrodes receive the brain's electrical impulses, which are recorded on an EEG machine. This test can determine if epileptic seizures are present, which can cause coma.

Treatments and drugs

Coma is a medical emergency and the first indication is given to maintain breathing and circulation. Breathing, circulatory, and other supportive care may be needed.

Healthcare workers may order blood glucose testing or intravenous antibiotics, even before blood test results are available, the chances are that the person is diabetic or has a septic shock. affect the brain.

Treatment varies depending on what caused the coma. Sometimes surgery is needed to relieve pressure from brain edema. Other treatments may focus on addressing the underlying disease, such as diabetes, kidney failure, or liver disease.

Sometimes the cause of the coma can be completely reversed and the person will regain normal function. But if the brain damage is severe, the disability may remain permanent or consciousness may never be regained.

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