What Causes Coma or Comatose?
An injury to the brain causes a person go into a state of coma or comatose. This injury to the brain can be due to internal or external bleeding, build-up of toxins, increased blood pressure or loss of oxygen. The brain injury is reversible and temporary but in certain cases it can also become permanent. Disturbances in the brain's circulatory system or head trauma reasons nearly to 50 percent of coma or comatose cases in the America. Problems that leads to coma or comatose are:
- Swelling or bleeding in head caused because of the injuries to the head. The swelling which occurs due to trauma pushes the blood against the skull. Swelling can reason the push down on the brain stem, which may damage the Reticular Activating System or RAS - part of the brain that is the reason for awareness and arousal.
- Brain swelling can make a person enter into coma or comatose. Few reasons may cause brain tissue swelling like electrolyte imbalance, hormones or lack of oxygen, can lead to swelling.
- Internal bleeding inside the human brain can cause coma or comatose. Coma due to compression and swelling on the injured side of the brain may occur due to bleeding in the brain layers. This compression reasons the brain to shift, causing damage to the brainstem and the Reticular activating system (RAS). Cerebral aneurysms, tumors and high blood pressure, are non-traumatic bleeding reasons.
- A stroke can make a person slip into coma or comatose. Coma can occur due to loss of blood or no blood flow accompanied with swelling.
- Drastic change in the level of the blood sugar can lead to coma or comatose. Coma or comatose can occur to diabetes patients when the blood sugar levels are very high and is known as hyperglycemia. Low blood sugar level or Hypoglycemia, may also lead to a coma. When blood sugar level is corrected coma or comatose is reversible.
- Lack of oxygen supply leads to coma or comatose. Brain requires enough oxygen for proper functioning. Heart attack may result a sudden cut-off of oxygen and blood flow to brain, known as hypoxia or anoxia. After CPR survivors of heart attack. Coma may occur. Choking or drowning may also lead to oxygen deprivation.
- Bacterial brain infections can cause coma or comatose. Infections in central nervous system, such as encephalitis or as meningitis, may also leads to coma.
- Increase in the toxin level in the human body can lead to coma or comatose. Failure of disposal of substances which are commonly found in the body can accumulate to toxic levels. As an example, urea from kidney failure, carbon dioxide from a severe asthma attack, or ammonia due to liver disease can increase the toxic level of thee body. Alcohol and drugs used in large quantities affects neuron functioning in the human brain.
- Seizures can cause coma or comatose. A single seizure produces coma or comatose rarely. A continuous seizure also known as 'status epilepticus' is a repeated seizure which can reduce the brain from regaining. This will reason prolonged unconsciousness and coma. Coma or comatose and prolonged unconsciousness can be caused.
What are the Signs and Symptoms of Coma or Comatose?
The signs and symptoms of coma or comatose commonly are:
- The patients' limbs do not respond.
- Only reflex movements are observed and no response to painful stimuli.
- Breathing trouble
- Eyes are in closed condition.
- Depressed brainstem reflexes, for example the patients' eye pupils do not respond to light.
A coma which is a medical emergency needs immediate medical care.
What are the Risk Factors for Coma or Comatose?
Common risk factors for coma or comatose include no direct reason to coma but they are associated in some way. Risk factors do not always lead to coma or comatose but the chances due that are high. It does not mean that if there are no symptoms of the risk factors that does not mean a person cannot enter into coma or comatose.
What are the Complications of Coma or Comatose?
Even though most people recover slowly from coma or comatose there is a chance for persistent vegetative state or death. Patients who recover from coma may also have disabilities that may be minor or major depending on the damage caused to the brain.
The complications which are developed because of coma or comatose include bladder infections, blood clots in the legs, pressure sores and other minor problems.
What Tests are Conducted to Diagnose Coma or Comatose?
Since coma or comatose patients cannot express anything by themselves, physical clues are needed for doctors to test and diagnose along with the information from friends and families. Information required includes:
- The affected person's medical history.
- Most recent changes in the patient's behavior health.
- Events that happened before the person slipped into coma or comatose, like headaches or vomiting.
- Information about affected person and how they lost consciousness.
- Notable symptoms or signs prior to coma or comatose.
- Drug usage both prescribed and used illegally.
Physical Test for Coma or Comatose
During physical examination for coma or comatose, physicians need to check the affected person's condition, their response to painful stimuli, pupil size and reflexes and movements. Observation breathing patterns should be observed by the doctor who helps to diagnose the coma's reason. Skin signs will also examined by the doctors if there are any injuries involved.
To determine the affected person's level of consciousness, doctors may press on the angle of the jaw or nail bed or speak loudly. Doctors watch the signs of arousal, such as, eyes movement or opening, vocal noises.
Reflexive eye movements will be tested by doctors who help to determine the location of brain damage and the reason of the coma or comatose.
Ice-cold water is used in patient's ear canals by the doctor to observe the eye reactions.
Lab Tests for Coma or Comatose
Blood samples of the patient affected with coma or comatose will be taken to check for:
- Carbon monoxide poisoning/ CO Poisoning
- Complete blood count or CBC Test
- Alcohol or drug overdose
- Electrolytes, thyroid, liver function and glucose kidney.
A spinal tap or lumbar puncture will check for infection symptoms in nervous system. During a spinal tap, specialist or physician will insert a needle in the spinal canal and a small amount of fluid for analysis.
Tests to Scan the Brain for Coma or Comatose
Imaging tests for coma or comatose patients will help doctors to identify pinpoint areas which occur due to brain injury. These tests for coma or comatose may include:
- CT scan/ Computerized Tomography Scan. A detailed image of brain can be identified using series of X-rays with the help of CT scan. A CT scan can show tumors, brain hemorrhage, strokes and some other conditions. It can be used to determine and diagnose the reason of a coma or comatose.
- MRI/ Magnetic resonance imaging. Magnets and powerful radio waves are used to create a detailed view of the brain. An MRI will help to identify brain tissue damaged by a brain hemorrhages, ischemic stroke and other conditions. Deep brain structures and brainstem can be examined by MRI scans.
- EEG/ Electroencephalography. Electrical activity which occurs inside the brain can be identified using EEG. A small electrode is attached to the scalp by doctors and they send low electrical current with the help of the electrodes and the brain's electrical impulses are recorded. EEG (Electroencephalography) determines whether seizures may be the reason for a coma or comatose.