How Coma Occurs? & What Happens in Coma?

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How Coma Occurs? & What Happens in Coma?

Coma is a State  where consciousness or wakeful state of mind is altered severely and is due to Depressed or decreased Brain Function.

Definition of Coma??

Coma is defined as State of Altered Consciousness  from which an individual can not aroused Easily.

Consciousness is the State of Self and Environment

In Contrast ,

The Term Confusion Indicates Lack of Clarity & Coherent Thoughts ,Perception, Understanding or Action.

Another Similar Term “Stupor” is defined as Disturbed Consciousness from which the Patient/Client can be aroused by vigorous External Stimuli.

Consciousness is maintained by Active Cerebral Cortex, under the influence of Ascending Reticular Activating System, Originating from Upper Brain Stem( Pons & Midbrain) Through Thalamus Radiating Diffusely to entire Cortex.

  • Unconsciousness may be Brought on by Functional or Structural Disturbances due to : 1. Large Areas of Cerebral Cortex(Usually Both Hemispheres) , 2. Upper Brain Stem Structures.

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How Coma Occurs?Causes of Coma ➡

Causes of Coma Include Primary Neurological Disorders, Various Systemic Disorders & Toxins which can impair Brain Function.

Primary Neurological Disorders

Cerebral Hemispherical Lesions

Brain Tumours
Abscess
Cerebral Infarcts(Large)
Sub-arachnoid Haemorrhage
Cerebral Haemorrhage
Subdural Haematoma
Hydrocephalus

Brain-Stem Lesions

Infarts
Haemorrhage
Posterior Fossa mass Lesions
Wernicke's Encephalopathy

Combination of Cerebral Hemispherical & Brain-Stem Lesions 

Trauma
Meningitis, Encephalitis
Anoxia
Severe Shock States
Post-ictal State Following a Generalised Fit
Sedatives/Hypnotics
Reye's Syndrome

Systemic Disorders

Metabolic Encephalopathies

Hypoglycaemia , Hyperglycaemia with or without Ketosis
Hyponatraemia
Anoxia,Hypercapnia, Hyperpyrexia
Hypo or Hyperosmolar States
Uraemic & Hepatic Encephalopathy
Severe Peripheral Circulatory Failure

Miscellaneous

Toxic Encephalopathies Secondary to Systemic Infections
Hypertensive Encephalopathy
Poisoning

Causes of Coma Based on the Rapidity of Evolution(or Progression)

Abrupt (Within Second & Minutes)

Cerebral Haemorrhage
Subarachnoid Haemorrhage
Massive Cerebral Infarct
Cardiac Arrest
Epileptic Fit
Trauma

Acute(within a Few Hours)

Cerebral infarct or Haemorraghe
Acute Poisoning-Alcohol,Drugs
Hypoglycaemia in Diabetics due to overdosage of insulin or oral Hypoglycaemics

Subacute (within several Hours & a Few Days)

Metabolic Encephalopathies
Brain Tumours
Encephalitis & Meningitis
Toxic Encephalopathies

 

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