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Name: Coma
Description: NINDS
This casebook is published and has been read 54 times.
The author of this casebook has identified the following medical topics as being highly relevant to this casebook.
A coma, sometimes also called persistent vegetative state, is a profound or deep state of unconsciousness. Persistent vegetative state is not brain-death. An individual in a state of coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as head trauma. . Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands.
Once
an individual is out of immediate danger, the medical care team focuses
on preventing infections and maintaining a healthy physical state. This
will often include preventing pneumonia and bedsores and providing
balanced nutrition. Physical therapy may also be used to prevent
contractures (permanent muscular contractions) and deformities of the
bones, joints, and muscles that would limit recovery for those who
emerge from coma.
The
outcome for coma and persistent vegetative state depends on the cause,
severity, and site of neurological damage. Individuals may emerge from
coma with a combination of physical, intellectual, and psychological
difficulties that need special attention. Recovery usually occurs
gradually, with some acquiring more and more ability to respond. Some
individuals never progress beyond very basic responses, but many
recover full awareness. Individuals recovering from coma require close
medical supervision. A coma rarely lasts more than 2 to 4 weeks. Some
patients may regain a degree of awareness after persistent vegetative
state. Others may remain in that state for years or even decades. The
most common cause of death for someone in a persistent vegetative state
is infection, such as pneumonia.
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