Coma – Understanding the Underlying Problems

comaPeople suffering from brain diseases usually enter a coma. The coma is a condition described as a symptom or effect of the underlying illness. The state also comes in different levels.

Some people can enter a coma for a few hours only while others can stay in it for weeks or months. The goal of doctors and families is to improve the condition of the patient and provide for all his needs even if he is in an unconscious state. Knowing more about the possible risks, causes and effects will be helpful in treatment and stability.

Describing Coma

When people with brain diseases enter a coma, they are generally unconscious and are unresponsive to stimuli. Coma is also known as comatose and is quite different from sleep. The person is alive but the brain is only working at very low levels so alertness is very limited. People in this state will remain unresponsive to voices, light and other external stimuli.

Patients cannot wake up from the state in the same manner that others awaken from sleep. The levels of unconsciousness should properly be monitored by health practitioners to determine how well the brain is functioning. The objective is to help the person recover consciousness and awaken from the state by providing for all his needs and improving the overall condition of the brain.

Coma Levels: The Glasgow Scale

The Glasgow coma scale is the gold standard monitoring chart that will help health practitioners determine how deep or severe the comatose state of any given person is. Some individuals are described as being only in a light or mild comatose while others are deeply into the condition and will not be responsive to any kind of stimuli. Some unconscious patients might still respond a little to visual or auditory stimuli. Others might show minimal movement or try to move their eyes or eyelids. Some can exert pressure while others can hear and listen to commands.

Looking at the Glasgow coma scale will help doctors determine who well the patients are responding to treatment too. Over time, patients will hopefully score better on the scale until they are finally responsive to stimuli and eventually wake up. The coma scale will be checked every few hours as recommended by the doctor and depending on the seriousness of the brain diseases. It is a very useful assessment tool for any unconscious individual.

Coma Causes

The causes of a comatose will vary. When insufficient blood is distributed to the brain, the person will generally faint and possibly fall into a state of comatose.

Problems in the brain will lead to the condition due to bleeding, inflammation and damage. The presence of infection is also known to trigger the condition. When different regions of the brain are affected, the person will start to exhibit symptoms and other untoward reactions. The RAS or reticular activating system is a vital part of the brain stem which is responsible for sleep and consciousness.

If this part is damaged, injured or not working properly due to insufficient nutrients, oxygen and blood supply, the person can become comatosed. When the state is achieved, the person has either shut down both hemispheres of the brain or the RAS has a dysfunction. The RAS will cease to function during a pre-death event or when there’s added swelling inside the brain that exerts a lot of pressure on the brain stem. The second reason for cessation of function involve brain stem stroke wherein cells in a particular part of the brain will lose blood and oxygen thereby deactivating the RAS.

Testing And Assessing Coma

When patients with brain diseases are diagnosed with the condition and fall into a coma, doctors will perform a number of tests to see which part of the brain is affected and if the condition stems from another underlying illness.

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Some of the diagnostic procedures include a CT scan, blood tests and ECG or electrocardiogram of the patient’s head. More tests are done based on the condition of the patient and if there are other possible conditions present. The diagnostic procedures will also be useful in pointing out the specific part that needs to be attended by the surgeon in case surgical intervention is needed.

The evaluation will also determine other possible risks and current illnesses. The prognosis of the patient will largely depend on the underlying factor. Some patients enter the state due to brain hemorrhage, cancer, stroke and other serious illnesses. The patient can get better if the main cause is treated. The patient can also die if he is suffering from a very serious and incurable disease.

Life After Coma

Many coma patients actually recover fully from the condition after a few days or weeks. There are also others who stay in the state for several months and only rely on mechanical and technological devices to stay alive. In some cases, families may decide to remove artificial support if the patient’s condition is gradually deteriorating and the Glasgow coma scores do not improve over the months. The patients who recover fully, however, will initially wake up from unconsciousness. The objective of the family is to ensure that the main cause is attended to and the patient copes with the debilitating effects if there are any present afterwards.

Therapy and other programs to restore strength, function and cognition will be very effective. The coma patient can undergo occupational therapy, physical therapy, visualization interventions and other programs that will encourage independence and restore his health. Many individuals who recover from the state can resume work or go back to school.

Many people do not experience the same problem again such as in the case of coma stemming from accidents and injury. Those with more serious conditions, however, will need to provide well for their needs. Medications have to be taken religiously and the person needs to adopt to new lifestyle changes to ensure that health is not compromised and reoccurrence is avoided. The condition should be taken seriously be families and patients. Report anything unusual after treatment and recovery.