Materiały źródłowe

• #1 Coma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coma/symptoms-causes/syc-20371099

  Coma is a state of prolonged loss of consciousness. […] A coma doesn’t usually last longer than several weeks. People who are unconscious for a longer time might transition to a lasting vegetative state, known as a persistent vegetative state, or brain death. […] The symptoms of a coma commonly include: Closed eyes. Depressed brainstem reflexes, such as pupils not responding to light. No responses of limbs except for reflex movements. No response to painful stimuli except for reflex movements. Irregular breathing. […] Although many people gradually recover from a coma, others enter a persistent vegetative state or die. Some people who recover from a coma end up with major or minor disabilities.

• #2 Coma | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/coma

  Coma is a state of consciousness that is similar to deep sleep, except no amount of external stimuli (such as sounds or sensations) can prompt the brain to become awake and alert. […] A person in a coma cant even respond to pain. […] Coma occurs when there is a serious problem with the brains arousal system (the reticular activating system), or with its communications between other brain areas (such as the cerebral hemispheres) and the brains activity becomes impaired. […] In some cases a person can descend into a persistent vegetative state, where the brain has lost its higher functions (including consciousness, self-awareness and personality) but retains involuntary functions such as breathing and swallowing, heart rate and blood pressure. […] The symptoms of coma include: The person looks like theyre asleep. No amount of sensory stimulation can wake them up. They may be breathing unusually. They may be holding their body in an unusual posture. Their pupils may be affected in a number of different ways. For example, one pupil is larger than the other or both pupils are constricted.

• #3

  https://www.aurorahealthcare.org/services/neuroscience/brain-skull-base-care/coma

  When your brain activity is disrupted, you may slip into an unconscious state known as a coma. When this occurs, you won’t be responsive or have any awareness of the world around you. A person can be comatose for a few hours, days or longer. […] Coma symptoms, outcomes and treatment depend on the severity and cause. […] A coma is a state of prolonged unconsciousness. You may appear to be in a deep sleep, but you wont wake or respond to any stimulation including pain. Its common to wake gradually after a coma within a few days or weeks. The length and severity of a coma depends on the underlying cause. […] There are three main symptoms that commonly define a coma. These include: Unconsciousness (a deep sleep with no response to stimuli), Lack of eye response (eyes closed with no response to light or movement), Lack of motor response (limbs dont respond or voluntarily move).

• #3

  https://www.aurorahealthcare.org/services/neuroscience/brain-skull-base-care/coma

  There are four stages of a coma that follow a typical pattern. The length of each stage varies by person. […] Your care team will closely monitor your vital signs and symptoms to track your stage and progress. […] Comas due to a severe state of brain dysfunction may last longer for months or even years. […] If the coma is prolonged, breathing, nutrition and heart function assistance will be needed. This state can be permanent, but its possible to wake. Those that do wake usually dont recover brain function. […] After a serious medical emergency, a medically induced coma may be recommended to help prevent further brain damage. […] Brain death is usually the result of a severe and catastrophic brain injury.

• #4 Coma – Wikipedia

  https://en.wikipedia.org/wiki/Coma

  A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. The person may experience respiratory and circulatory problems due to the body’s inability to maintain normal bodily functions. People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia or blood clots. Coma patients exhibit a complete absence of wakefulness and are unable to consciously feel, speak or move. Comas can be the result of natural causes, or can be medically induced, for example, during general anesthesia. […] The severity and mode of onset of coma depends on the underlying cause. There are two main subdivisions of a coma: structural and diffuse neuronal. A structural cause, for example, is brought upon by a mechanical force that brings about cellular damage, such as physical pressure or a blockage in neural transmission. By contrast, a diffuse cause is limited to aberrations of cellular function which fall under a metabolic or toxic subgroup. Toxin-induced comas are caused by extrinsic substances, whereas metabolic-induced comas are caused by intrinsic processes, such as body thermoregulation or ionic imbalances (e.g. sodium). For instance, severe hypoglycemia (low blood sugar) or hypercapnia (increased carbon dioxide levels in the blood) are examples of a metabolic diffuse neuronal dysfunction. Hypoglycemia or hypercapnia initially cause mild agitation and confusion, but progress to obtundation, stupor, and finally, complete unconsciousness. In contrast, coma resulting from a severe traumatic brain injury or subarachnoid hemorrhage can be instantaneous. The mode of onset may therefore be indicative of the underlying cause.

• #4 Coma – Wikipedia

  https://en.wikipedia.org/wiki/Coma

  Comas can last from several days to, in particularly extreme cases, years. Some patients eventually gradually come out of the coma, some progress to a vegetative state or a minimally conscious state, and others die. Some patients who have entered a vegetative state go on to regain a degree of awareness; and in some cases may remain in vegetative state for years or even decades such as the Aruna Shanbaug case or Edwarda O’Bara. Predicted chances of recovery will differ depending on which techniques were used to measure the patient’s severity of neurological damage. Predictions of recovery are based on statistical rates, expressed as the level of chance the person has of recovering. Time is the best general predictor of a chance of recovery. For example, after four months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low. The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage. A deeper coma alone does not necessarily mean a slimmer chance of recovery; similarly, a milder coma does not indicate a higher chance of recovery. The most common cause of death for a person in a vegetative state is secondary infection such as pneumonia, which can occur in patients who lie still for extended periods.

• #5 Coma | healthdirect

  https://www.healthdirect.gov.au/coma

  A coma is a medical emergency and the person in the coma needs urgent treatment in hospital. If someone is unconscious or not responding to you, call triple-zero (000) and ask for an ambulance immediately. […] If someone is in a coma, they are alive but they are not conscious and don’t respond to the world around them. […] A coma can result from brain injuries or from illnesses affecting the brain, such as stroke. […] Someone in a coma needs intensive care in hospital and may need help with breathing. […] Some people recover from a coma, but others remain in a non-responsive state. […] Whether someone recovers from a coma depends on what caused the coma, how severe it is and how long it lasts. […] When someone is in a coma, they are unconscious and they cannot be woken up. […] Someone who is in a coma is alive but completely unresponsive to the world around them.

• #5 Coma | healthdirect

  https://www.healthdirect.gov.au/coma

  There is very little activity in their brain. […] A coma can result from a severe illness or injury. […] It is a medical emergency and the person in the coma will need immediate treatment in hospital. […] Some people in a coma can breathe on their own but others will need help. […] They won’t be able to cough or swallow and they won’t respond to pain, light or sound. […] Their eyes will be closed and they won’t be able to move or communicate. […] There are different levels, or depths, of coma. […] Hospital staff will examine a person to measure the depth of their coma. […] Comas usually don’t last longer than 4 weeks, although cases have been recorded where people stay in a coma for several years. […] Some people will come out of a coma, but others will continue to be unresponsive or may die.

• #6 Coma: Types, Causes, Treatments, Prognosis

  https://www.webmd.com/brain/coma-types-causes-treatments-prognosis

  A coma is a prolonged state of unconsciousness. During a coma, a person is unresponsive to their environment. […] A coma is caused by an injury to the brain. Brain injury can be due to increased pressure, bleeding, loss of oxygen, or buildup of toxins. The injury can be temporary and reversible. It also can be permanent. […] Although it may seem like someone in a coma is sleeping, there are signs and symptoms that tell you that it is more than just sleep. They include: They are unable to be woken up. They have no eye response (deep coma). If you lift their eyelids, their eyes don’t react by blinking or moving. Their pupils don’t dilate (widen) when you lift their eyelids and shine a light into their eyes. They have no motor responses (deep coma). If you apply pressure on a part of their body, they don’t pull away or respond. They have irregular breathing. Their blood pressure may be higher or lower than normal, depending on the coma cause. Their muscles may contract (pull in) in positions that seem unnatural.

• #6 Coma: Types, Causes, Treatments, Prognosis

  https://www.webmd.com/brain/coma-types-causes-treatments-prognosis

  For most people, there are four stages to a coma, and there is no way of knowing how long anyone will be in any stage. Stage I is the coma itself. This is followed by: Stage II: In this stage, the person may start responding to some commands, such as to open their eyes. They may react to sound, like your voice or a door opening and closing. If they have pain, such as when someone gives an injection or takes blood, their arm may flinch or they may try to pull away. Stage III: This stage is when the person is more awake but is confused and may be agitated. You may see a personality change. A normally sweet, quiet person may start to yell or swear and try to hit out. If the person becomes a danger to themselves (hitting out could cause them to hit their bedrail or pull out IVs or other tubes), the staff may have to put soft restraints on their wrists. Stage IV: This last stage is when the person is completely awake and can do simple routine things, such as sitting up and eating. However, if the recovery is only partial, they may have difficulty performing these tasks. […] A coma can last anywhere from a few minutes to a few weeks. Although there can be exceptions, longer coma generally lead to a persistent vegetative state or brain death.

• #7 Coma: Types, Causes, Treatments, Prognosis, and More

  https://www.healthline.com/health/neurological-health/coma

  A coma is a prolonged state of unconsciousness. It occurs when a temporary or permanent disruption of the brains function severely affects consciousness. This damage results in: […] A person who is in a coma is alive but unable to move at will. In most instances, they cant think, speak, or respond to their environment. Important functions like breathing and blood circulation are impaired in most cases. […] Some people wake up gradually from a coma, typically after a few weeks. Others, however, may remain in comas for years or even decades, kept alive by nutritional supplementation as well as breathing and heart function assistance. […] A coma is diagnosed when a person has remained in a state of decreased consciousness and meets certain criteria, such as: […] People in a coma may still swallow and cough on their own.

• #7 Coma: Types, Causes, Treatments, Prognosis, and More

  https://www.healthline.com/health/neurological-health/coma

  Sometimes, people in a coma can breathe without assistance, but other times, they need a machine, like a ventilator, to help them. […] Many times, a person will recover from a coma after a few weeks. The recovery is usually gradual. […] Some people recover from a coma without any lasting symptoms. Others many have lifelong conditions due to damage to their brain, and may need physical therapy or occupational therapy. […] Its not always possible to predict how well a person will recover from a coma, but there are a few factors that play into it, such as: […] In many cases, a coma lasts for a few weeks. But, some people may remain in a coma for much longer. Long-term outcomes depend on what caused the coma and the site and extent of damage to the brain. […] Some people emerge from a coma with physical, intellectual, or psychological conditions. And some people recover from a coma without any lasting symptoms. […] People who remain in a coma for more than a year are unlikely to come out of that state but thats not always the case. In more severe coma situations, it can be difficult to assess when someone will wake up.

• #8 Coma: What It Is, Causes, Diagnosis, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/6007-coma-persistent-vegetative-state

  Being in a coma means youre unconscious, unaware and unresponsive to whats happening around you. […] Comas have levels of severity, and some are deeper meaning the severity of brain activity disruption is greater than others. […] A coma is a medical emergency. […] Generally, having a score of 8 or less means youre in a coma. The lower the score, the deeper the coma is. […] A coma can be very brief and last only a few minutes, or it can last as long as one to two weeks. […] Comas rarely last longer than a couple of weeks because people tend to emerge from the coma and wake up or shift into another state of decreased or minimal consciousness. […] A vegetative state is similar to a coma but isnt the same. […] The potential for recovery from a vegetative state varies widely. Some people recover consciousness fully or partially, but most dont. […] The outlook for a coma can vary widely, and many factors play a role.

• #9 Coma: Causes, diagnosis, treatment, and outlook

  https://www.medicalnewstoday.com/articles/173655

  A person in a coma cannot respond or make voluntary actions to pain, light, or sound in the usual way. […] A person in a coma may be able to hear sounds in their environment. […] If a coma results from a severe injury to the brain or a subarachnoid hemorrhage, the symptoms may appear suddenly. […] The possible complications of a coma relate to the following: inability to respond to body stimuli, causing incontinence of the bladder and bowel; inability to move, which may result in bedsores, or pressure ulcers; inability to handle respiratory secretions, meaning pneumonia could develop. […] An overall score of 8 or less indicates a coma. The condition is moderate if the overall score is 9-12. If the overall score is 13 or more, the impairment to consciousness is minor. […] If brain damage has occurred, a long-term impairment may result. If the person awakens, they may need to relearn basic skills, and they may not remember what happened.

• #9 Coma: Causes, diagnosis, treatment, and outlook

  https://www.medicalnewstoday.com/articles/173655

  A coma can last from a few days to a few weeks. The outcome will depend on the cause and any brain damage that has occurred. […] During a coma, a person does not react to external stimuli, and they will not show normal reflex responses. […] Depending on the cause and the extent of damage, a coma can occur rapidly or gradually, and it can last from several days to months, though most last from days to weeks. […] A coma is a deep state of unconsciousness. The outcome of a coma depends on the cause and severity of the damage a person has sustained or the diagnosed condition. […] However, in severe cases, a persons condition may not change after an extended period. Doctors may reclassify them as being in a persistent vegetative state. If this state lasts for months, a person may be unlikely to wake up.

• #10 When death is near: Signs and symptoms – Hospice Foundation of America

  https://hospicefoundation.org/when-death-is-near-signs-and-symptoms/

  Patients who begin hospice care earlier in their illness may not experience any symptoms for many months. But as death approaches, you may notice some of these changes. […] Near the end of life, vital signs such as blood pressure and heart rate may fluctuate or gradually decrease. […] Skin may become purplish, pale, gray, or blotchy, especially on the knees, feet, buttocks, ears and hands. This is often a sign that death will occur within days or hours. […] Pain may increase as the disease progresses, chronic conditions such as arthritis or stiff/inflamed joints worsen, or pressure injuries to the skin increase. […] Near the end of life, breathing (respiration) may become irregular. Your loved one may have periods of rapid breathing or stop breathing for a short time. […] When death is near, breathing changes to a new pattern. Instead of a normal rate and rhythm, you may notice several rapid breaths followed by a period of no breathing, called apnea. […] Before death, many people become completely unresponsive. In this deeply unconscious or coma-like state, they cannot be roused, will not open their eyes, and are unable to communicate or respond to touch.

• #11 The types, symptoms, and diagnosis of coma: An Overview | Medanta

  https://www.medanta.org/patient-education-blog/coma

  A coma is a protracted state of unconsciousness that can be brought on by a number of conditions, including a brain tumor, a stroke, a catastrophic head injury, drug or alcohol intoxication, or even an underlying ailment like diabetes or an infection. […] Very Few people remain in a coma for more than a few weeks. Longer periods of unconsciousness have the potential to lead to brain death or a permanent vegetative state. […] When a person fits certain prerequisites and has persisted in a condition of diminished consciousness, such as: Closed eyes, Unresponsiveness, Not able to breathe himself, No limb response other than reflexes(basic), There is no reaction to pain other than reflexes. […] Coma patients may still be able to swallow and cough on their own. […] People who are in comas rarely breathe on their own, but mostly they require the assistance of a machine, such as a ventilator.

• #12 Vegetative State: Meaning, Symptoms, and Recovery Signs

  https://brainfoundation.org.au/disorders/vegetative-state/

  A vegetative state is when a person is awake but showing no signs of awareness. On recovery from the coma state, VS/UWS is characterised by the return of arousal without signs of awareness. […] A person in a vegetative state may open their eyes, wake up and fall asleep at regular intervals and have basic reflexes, such as blinking when theyre startled by a loud noise, or withdrawing their hand when its squeezed hard. […] However, a person in a vegetative state doesnt show any meaningful responses, such as following an object with their eyes or responding to voices. […] VS/UWS patients eyes might be in a relatively fixed position, may track moving objects (visual pursuit), or move in a completely unsynchronised manner. […] If a person is diagnosed as being in a permanent vegetative state, recovery is extremely unlikely but not impossible.

• #12 Vegetative State: Meaning, Symptoms, and Recovery Signs

  https://brainfoundation.org.au/disorders/vegetative-state/

  Many patients emerge spontaneously from VS/UWS within a few weeks. Some people improve gradually, whereas others stay in a state of impaired consciousness for years. Many people never recover consciousness. […] The chances of recovery depend on the extent of injury to the brain and age, with younger patients having a better chance of recovery than older patients. […] The longer a patient is in VS/UWS the more severe the resulting disabilities are likely to be. […] Some patients who have entered a vegetative state go on to regain a degree of awareness (see Minimally Conscious State). The likelihood of significant functional improvement for VS/UWS patients diminishes over time.

• #13 Coma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/coma?content_id=CON-20371086

  Coma is a state of prolonged loss of consciousness. It can have a variety of causes, including traumatic head injury, stroke, brain tumor, or drug or alcohol intoxication. A coma may even be caused by an underlying illness, such as diabetes or an infection. […] A coma doesn’t usually last longer than several weeks. People who are unconscious for a longer time might transition to a lasting vegetative state, known as a persistent vegetative state, or brain death. […] The symptoms of a coma commonly include: Closed eyes. Depressed brainstem reflexes, such as pupils not responding to light. No responses of limbs except for reflex movements. No response to painful stimuli except for reflex movements. Irregular breathing. […] Although many people gradually recover from a coma, others enter a persistent vegetative state or die. Some people who recover from a coma end up with major or minor disabilities. […] Recovery usually occurs gradually. A person with severe brain damage might have permanent disabilities or never regain consciousness.

• #14 Coma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430722/

  Coma represents brain failure. It may be caused by neuronal dysfunction from many causes including structural or nonstructural processes affecting the central nervous system. […] Metabolic or infectious etiologies may diffusely affect the brain and lead to a coma. […] Structural brain diseases such as subdural or epidural traumatic hematomas, spontaneous intracranial hemorrhages, venous thrombosis, tumors, acute hydrocephalus, raised intracranial pressure, anoxic brain injury, or brainstem strokes may all cause altered mental status or coma. […] The accepted pathophysiology of a coma involves neuronal dysfunction from a decrease in the supply of glucose or oxygen to the brain. […] Increased intracranial pressure is a frequent cause of coma. […] Patients with reversible causes of coma, such as hypoglycemia, may be discharged after the appropriate intervention and with consideration of a safe home environment. Patients with persistent coma need hospital admission with ongoing monitoring, supportive care, and targeted care to the underlying cause of coma.

• #15 Coma: Glasgow Coma Scale, Causes, and Diagnosis

  https://www.medicinenet.com/coma/article.htm

  The effect of trauma on the brain is not predictable. Relatively minor force to the skull and brain can be catastrophic. […] Bleeding within the brain (intracerebral hemorrhage) may be small, but also may cause associated swelling that may cause damage to the brain and result in coma. […] As the blood continues to accumulate, pressure builds within the skull and the brain is shifted away from the site of bleeding, compressing the brain against the skull. With both hemispheres of the brain compromised, loss of consciousness and coma may result. The more swelling, the higher the intracranial pressure, the deeper the coma. […] Just as blood takes up space within the skull and can cause coma, so may brain tumors. Brain tumors may be associated with localized swelling edema, inflammation, and bleeding.

• #16 What is encephalitis? Causes, Symptoms & Treatment | Encephalitis International

  https://www.encephalitis.info/what-is-encephalitis/

  Encephalitis may cause different symptoms depending on the type of encephalitis (e.g. infectious, autoimmune) with most common including: Fever, Headache, Seizures, Confusion, Memory problems, Uncharacteristic behaviour, Psychosis. […] Infectious encephalitis usually begins with a flu-like illness or headache followed by more serious symptoms hours to days, or sometimes weeks later. The most serious finding is an alteration in the level of consciousness. This can range from mild confusion or drowsiness, to loss of consciousness and coma. […] Sometimes a patient may be placed in an induced coma which is a temporary coma brought on by a controlled dose of drugs to shut down the brain and allow time to recover from the swelling caused by encephalitis. The doctors decide the length of the coma depending on the extent of injury and the way the patient reacts.

• #17 Evaluation of coma – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/417

  Coma is the absence of consciousness. […] This state of unarousable unconsciousness includes the failure of eye opening to stimulation, a motor response no better than simple withdrawal-type movements, and a verbal response no better than simple vocalization of nonword sounds. […] The complete loss of awareness with preserved wakefulness and wake-sleep-cycles. […] Consciousness is impaired due to compression of ARAS components. […] Loss of consciousness is typically abrupt with cranial nerve palsies. […] The ARAS is a complex system with some redundancy of pathways that are involved in arousal and maintenance of wakefulness. […] This may explain the recovery of the arousal system after initial coma, almost always within 3 weeks from coma onset in most patients.

• #18 Diabetes-Related Coma: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16628-diabetic-coma

  A diabetes-related coma is a life-threatening complication that can result from very high blood sugar (hyperglycemia) or very low blood sugar (hypoglycemia). A coma is a prolonged, deep state of unconsciousness. People in comas are unresponsive but still alive. […] A person in a diabetes-related coma needs immediate medical attention. Call 911 or your local emergency number. […] If you dont get treatment for HHS in time, it can lead to a coma. […] If you dont get treatment for DKA in time, it can lead to a coma. […] Prolonged severe hypoglycemia thats not treated in time can lead to a coma. […] HHS and DKA can both cause severe dehydration, which can trigger a coma. As your brain needs glucose to function, a severe lack of glucose from low blood sugar can cause your brain to shut down and go into a coma.

• #19 Diabetic coma | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma

  The 3 types of diabetic coma include diabetic ketoacidosis coma, hyperosmolar coma and hypoglycaemic coma. […] Diabetic coma is a medical emergency and needs prompt medical treatment. […] Uncontrolled diabetes may lead to a diabetic coma or unconsciousness. […] Common causes of ketoacidosis include a missed dose of insulin or an acute infection in a person with type 1 diabetes. […] Symptoms of ketoacidosis are: extreme thirst, lethargy, frequent urination (due to high blood glucose levels), nausea, vomiting, abdominal pain, progressive drowsiness, deep, rapid breathing, a fruity or acetone smell on the breath. […] A diabetic hyperosmolar coma is caused by severe dehydration and very high blood glucose levels (hyperglycaemia). […] Hyperosmolar coma develops slowly over several days or weeks, so if the high blood glucose levels or dehydration are detected and treated early, coma can be prevented.

• #19 Diabetic coma | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetic-coma

  If the blood glucose falls to very low levels, the person may become unconscious (hypoglycaemic coma) and seizures may occur. […] Prolonged or frequent coma should be avoided and hypoglycaemia needs to be treated quickly. […] A coma is a medical emergency. A quick diagnosis can save the person’s life. […] Treatment options for diabetic coma include: ketoacidotic coma – intravenous fluids, insulin and administration of potassium; hyperosmolar coma – intravenous fluids, insulin, potassium and sodium given as soon as possible; hypoglycaemic coma – an injection of glucagon (if available) to reverse the effects of insulin or administration of intravenous glucose.

• #20 What Are the Stages of a Coma?

  https://www.gkbm.com/blog/what-are-the-stages-of-a-coma/

  After sustaining a brain injury, there is a risk of going into a coma. Typically a coma will last between two and four weeks. While it may be a long recovery process, some telltale signs in each stage can indicate how someone is progressing while coming out of a coma. Coma patients are monitored carefully through the following four stages of recovery before they can determine the full extent of their brain injury and prognosis. […] During the unresponsive stage, a patient typically does not respond consistently. The unresponsive stage is referred to as a coma. Patients in the unresponsive stage may have reflexive responses and random movements for no specific reason. […] During this stage, the patient will begin to respond to stimuli. Responses will be less random but slow and inconsistent. Some early responses may include movement to sound and touch, or opening and closing eyes, or gripping and releasing hands when prompted to do so.

• #20 What Are the Stages of a Coma?

  https://www.gkbm.com/blog/what-are-the-stages-of-a-coma/

  At this stage, a patient may respond more consistently. They may also be confused about where they are and what has happened and have memory difficulties. The patient may present behavioral issues, such as outbursts, swearing, biting, or physical aggression. […] At this stage, a patient may be able to complete routine tasks without difficulty. However, they may still have issues with problem-solving, judgment, and decision-making. A patient at this stage may not be fully aware of their limitations. Family and friends might notice some personality changes at this stage as well. […] The recovery process is different for everyone, and some patients could stay in one stage longer than the other.

• #21 What are the signs of improvement? | University of Iowa Health Care

  https://uihc.org/health-topics/what-are-signs-improvement

  During this stage the patient does not respond consistently or appropriately. You may hear this stage referred to as a coma. You may notice different movements in the patient. These are referred to as reflexive or generalized responses. […] During this stage the patient starts to respond to things that are happening to them. The responses will be more appropriate, but may be inconsistent or slow. The patient will start to have localized responses and follow simple commands. […] At this stage the patient is responding more consistently. The patient will be confused about where he or she is and what has happened. The patient will have difficulty with memory and behavior. […] The patient completes routine tasks without difficulty, but still needs help with problem solving, making judgments and decisions. The patient may not understand his or her limitations and safety is a big concern.

• #22 What are the 10 Recovery Stages After a Brain Injury? – NeuLife

  https://neuliferehab.com/what-are-the-10-recovery-stages-after-a-brain-injury/

  A coma allows the brain to heal; uninterrupted. With a severe injury, the patient may remain in a coma for some time. This is considered the first stage of recovery. […] What is a coma? It is the deepest state of unconsciousness. Generally, coma patients have no eye movement, no purposeful movement, and lack speech and communication. The patient is unresponsive to the environment and does not wake, even with stimulation. […] Comas can last from weeks to months or even years. […] After awakening from a coma, the patient may move through further stages towards recovery.

• #23 What Are the Stages of a Coma?

  https://www.starhealth.in/answers/what-are-the-stages-of-a-coma/

  Coma is a deep state of unconsciousness where the person does not react to any external stimuli, usually having their eyes closed. They display minimal to no motor or reflex activity, with potential abnormality in respiration patterns. […] The intensity and duration of the coma may vary, and understanding its phases, categories, symptoms, causes, and therapy is important for effective management. […] Comatose patients are monitored meticulously throughout the four subsequent recovery stages as follows: […] During this first stage, patients usually respond with a lack of consistent reaction, usually called a coma. Although they may present reflex behaviours and occasional movements, they do not appear as responses to particular stimuli. […] During this stage, patients begin to react to external stimuli. Even though the response remains slow and intermittent, it is no longer random. Early responses can include movements to sound or touch and being able to open and close eyes or grasp and release hands upon command.

• #23 What Are the Stages of a Coma?

  https://www.starhealth.in/answers/what-are-the-stages-of-a-coma/

  At this stage, patients tend to show more regular responses but can get confused about their environment and recent events, with memory problems. Behavioural problems can occur, such as aggression, swearing, biting, or physical aggression. […] During this last stage, patients can handle everyday tasks with relative ease, though they may still have difficulty with problem-solving, judgment, and decision-making skills. […] The recovery process is different for every person, with some patients staying in a specific stage longer than others.

• #24 Predicting Coma Trajectories: The Impact of Bias and Noise on Shared Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8382106/

  Coma trajectories are characterized by quick awakening or protracted awakening. Outcome is bookended by restored functionality or permanent cognitively and physically debilitated states. […] Most patients who awaken quickly do well and can resume their pretrauma injury lives. In worse off, slow-to-awaken patients, outcomes are a mixed bag of limited innate resilience, depleted cognitive and physical reserves, and adjusted quality of life. […] In recovery of acute brain injury, nothing cannot be predicted with certainty, and we should harbor no illusions. No accepted easy tools (or even less easy tools, such as artificial intelligence) reliably estimate recovery of consciousness in comatose patients. Furthermore, the exact trajectory of coma recovery is often K-shaped. Patients paths diverge like the arms of the letter K; some follow a relentlessly downward trajectory, whereas others go up and improve day by day.

• #24 Predicting Coma Trajectories: The Impact of Bias and Noise on Shared Decisions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8382106/

  Most patients who awaken quickly do well, whereas patients who are severely injured or slow-to-awaken present significant ambiguity. Other factors, such as intuition, prior negative experiences, mood, tiredness, and secondary interest (avoidance of mortality counting as poor performance), influence clinician outcome prediction but are not easily measured. […] Recovery from coma usually occurs in stages: awakening, awareness, communication, and, later, return of an inner urge to become more dynamic, resulting in focus and motivation to reach new physical and mental objectives and goals. None of these stages is completely predictable, let alone clearly outlined, and they are etiology dependent.

• #25 Coma Signs, Types, Causes, Prevention & Treatment

  https://www.emedicinehealth.com/coma/article_em.htm

  A coma is a deep state of unconsciousness in which individuals do not consciously respond to stimuli in their environment. […] Patients in a coma are unable to think consciously and lack awareness of their surroundings, but they do retain basic life support functions, such as breathing and circulation. […] A long-term coma is often referred to as a persistent vegetative state. This can last for years, depending on the medical circumstances and the cause. […] In general, a coma is temporary, rarely lasting more than two to four weeks. After emerging from a coma, the prognosis is varied. Many people can recover fully, some require lifelong physical and occupational therapy, while others may recover only basic functions. […] The main symptom of a coma is unconsciousness. A patient in a coma will have no conscious response to external stimuli and may appear to be in a deep sleep.

• #25 Coma Signs, Types, Causes, Prevention & Treatment

  https://www.emedicinehealth.com/coma/article_em.htm

  If the coma is severe, even basic body functions such as breathing may be affected. […] In general, a coma is temporary, rarely lasting more than two to four weeks. After emerging from a coma, the prognosis is varied and typically depends upon the cause of the coma and the severity of the brain injury. […] For those who do recover, recovery is usually gradual. Many patients can recover fully. Some require lifelong physical and occupational therapy, while others may recover only basic functions.

• #26 What Happens in a Coma? The 4 Stages That Could Change Everything

  https://www.sriramakrishnahospital.com/blog/icu/identify-the-4-stages-of-coma-how-long-does-coma-last/

  Coma is a state of extended unconsciousness that can have many different origins, including but not limited to severe brain injury, stroke, brain tumour, drug or alcohol intoxication, or a chronic disease like diabetes or an infection. […] The average duration of a coma is a few weeks. Those who remain unconscious for extended periods may enter a chronic vegetative condition or die. […] Comas typically don’t last more than four weeks. After years in a chronic vegetative state, some individuals may gradually regain consciousness. […] The outlook for someone in a coma might be unpredictable. The likelihood of a full recovery is affected by several factors, including the nature of the underlying condition, the type of coma, the severity of the problem, and how long the coma has lasted. It’s not uncommon for someone to regain full functionality once the underlying issue is fixed. However, if the brain injury is very significant, the victim may never regain consciousness again or remain permanently incapacitated.

• #27 What is the Difference Between a Coma and Brain Death? | LifeSource

  https://www.life-source.org/latest/what-is-the-difference-between-a-coma-and-brain-death/

  Coma is a state of unarousable unresponsiveness. A coma is a deep state of eyes-closed unconsciousness where a person is not able to respond to people or the environment around them. In a coma, a patient is alive and there is some brain activity. Depending on the severity of the injury, recovery time varies and comas can be temporary or permanent. […] Patients in a coma might have brain stem responses, spontaneous breathing and/or non-purposeful motor responses. Coma has three possible outcomes: progression to brain death, recovery of consciousness, or evolution to a state of chronically depressed consciousness, such as a vegetative state.

• #28 Coma and reduced awareness states | Headway

  https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/coma-and-reduced-awareness-states/

  Length of PTA, as with length of coma, is important. This is the best indicator of severity of brain injury. […] A small number of people sustain a brain injury so severe that, although they emerge from coma and have sleep-wake cycles, they have no conscious awareness of themselves or their surroundings. […] If this condition persists for more than four weeks they can be classified as being in a continuing vegetative state. If it continues for 12 months after traumatic brain injury or 6 months after non-traumatic brain injury, the person can be classed as being in a permanent vegetative state. […] This is a condition distinct from coma and vegetative state as the person shows distinct but limited signs awareness and response to stimulation. However, they find it very difficult to remain aware or responsive for any length of time or in a predictable way.

• #28 Coma and reduced awareness states | Headway

  https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/coma-and-reduced-awareness-states/

  Whether it lasts for a few seconds or a few weeks, the usual immediate effect of brain injury is a loss of consciousness. Coma can be defined as a state of depressed consciousness where a person is unresponsive to the outside world. […] Injury to these areas causes decreased consciousness or coma. […] There are different levels of coma, ranging from very deep, where the patient shows no response or awareness at all, to shallower levels, where the patient responds to stimulation by movement or opening eyes. Still shallower levels can occur, where the patient is able to make some response to speech. Level of coma is usually initially assessed by the Glasgow Coma Scale (GCS). […] Recovery from coma is a gradual process, starting with the person’s eyes opening, then responding to pain, and then responding to speech. People do not just wake up from a coma, and say, 'Where am I?’ as is sometimes portrayed in films. The length of coma is one of the most accurate predictors of the severity of long-term symptoms. The longer the coma, the greater the likelihood of residual symptoms, particularly physical disabilities, although this is only a guide and some people can make good recoveries after an extended period in a coma.

• #29 Coma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coma/diagnosis-treatment/drc-20371103

  Because people in comas can’t express themselves, healthcare professionals must rely on physical clues and information provided by family members and friends. […] A coma is a medical emergency. Healthcare professionals typically first check the affected person’s airway and help maintain breathing and circulation. A person in a coma might need breathing assistance, medicines through a vein and other supportive care. […] Sometimes the cause of a coma can be completely reversed, and the affected person regains function. Recovery usually occurs gradually. A person with severe brain damage might have permanent disabilities or never regain consciousness.

• #30 Coma: Types, Causes, Treatment, Recovery, and Outlook

  https://www.verywellhealth.com/coma-8644695

  When a person is recovering from a coma, they may periodically open their eyes, begin to move, respond to touch or pain, or toss and turn in bed. They may also cough or try to pull out medical devices, such as intravenous (IV) catheters or breathing tubes. […] Many people can recover from a coma. If your loved one is in a medically induced coma, they are more likely to have a full recovery because the coma-inducing medication can be reversed when they become medically stable. […] If your loved one is in a comatose state due to a medical condition or a head injury, then the outlook and potential for recovery are highly variable based on their individual situation.

• #31 Coma | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/coma

  A coma is a state of unconsciousness where a person is unresponsive and cannot be woken. […] Someone whos in a coma is unconscious and has minimal brain activity. […] Over time, someone in a coma may start to gradually regain consciousness and become more aware. […] A coma can last for a prolonged period of time. The person might: start to gradually wake up and gain consciousness. […] Some people will make a full recovery and be completely unaffected by the coma. Others will have disabilities caused by the damage to their brain. […] The chances of someone fully recovering from a coma depend on: the severity of their brain injury, the cause of their brain injury, their age, how long theyve been in a coma, how physically fit they were before the coma. […] Its impossible to accurately predict how long a coma will last, whether someone will recover, and if theyll have any long-term problems.

• #32 Overview of Coma and Impaired Consciousness – Neurologic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/neurologic-disorders/coma-and-impaired-consciousness/overview-of-coma-and-impaired-consciousness

  Coma is unresponsiveness from which the patient cannot be aroused and in which the patient’s eyes remain closed. […] Impaired consciousness may progress to coma and ultimately to brain death. […] Diagnosis is clinical; identification of cause requires laboratory tests and neuroimaging. […] Impaired consciousness is diagnosed if repeated stimuli arouse patients only briefly or not at all. If stimulation triggers primitive reflex movements (eg, decerebrate or decorticate posturing), impaired consciousness may be deepening into coma. […] Prognosis for patients with impaired consciousness depends on the cause, duration, and depth of the impairment of consciousness. […] After coma, the following prognostic signs are considered favorable: Early return of speech (even if incomprehensible), spontaneous eye movements that can track objects, normal resting muscle tone, ability to follow commands.

• #33 Stupor and Coma – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/coma-and-impaired-consciousness/stupor-and-coma

  The various levels of impaired consciousness lethargy, obtundation, stupor, and coma have the same causes, of which there are many. […] Consciousness is impaired to varying degrees. People in a stupor are usually unconscious but can be aroused with vigorous stimulation. People in a coma are unconscious, with their eyes closed, and they cannot be aroused. […] In general, if people with impaired consciousness start to respond to sounds, touch, or other stimuli within 6 hours, they are more likely to recover. Recovery is also likely if one or more of the following occur within the first days: Speech returns, even if it is incomprehensible. The eyes can follow an object. People can follow commands. Muscle tone returns to normal. […] The likelihood of recovery also depends on the cause and duration of impaired consciousness, as in the following: Overdose of a sedative: Recovery is likely unless people stopped breathing long enough to cause brain damage. A low blood sugar level: Complete recovery is possible if the brain was not deprived of sugar for more than about 1 hour. Head injury: Substantial recovery may occur, even if the coma lasts several weeks (but not if it lasts more than 3 months). Stroke: Permanent brain damage is likely if coma lasts 6 hours or longer. Infection: Complete recovery is often possible if people are promptly treated. […] Having another disorder (such as diabetes mellitus, high blood pressure, or a lung or heart disorder), if it is severe, may negatively affect recovery.

• #34 Symptoms of an Alcoholic Coma | WhiteSands Alcohol & Drug Rehab

  https://whitesandstreatment.com/2024/11/25/what-is-an-alcoholic-coma/

  Alcohol coma symptoms usually arise from consuming a dangerous amount of alcohol, often referred to as an overdose. […] Excessive drinking can trigger signs of alcohol poisoning, which may cause breathing and heart rates to cease. When the brain lacks oxygen, the individual may lose consciousness and become unresponsive, resulting in the death of brain cells. This situation can lead to a coma, as the brain cannot respond or regain alertness until it heals by regenerating and reconnecting the damaged neurons. […] The severity of an overdose and the associated risk of coma depend on various factors, including the individuals health, the quantity of drugs consumed, and the promptness of medical intervention. […] Tragically, some overdoses can also result in death. It is important to note that the long-term effects of alcohol or drug abuse are not over once a person wakes up from a coma. An overdose can inflict lasting damage, especially to the brain.

• #35 Recovering from a Coma: Steps and Challenges

  https://lonestarneurology.net/blog/coma-recovery/

  A coma is a terrible condition. It is life-threatening for many people and puts relatives under severe stress. Recovery from a coma requires taking steps to regain consciousness, relearning skills, and understanding how the persons body was affected by this traumatic event. […] Recovery from a coma is a long and often complex process. Brain damage can range from mild to severe. Thus, it is difficult for us to predict recovery time as well as the severity of the effects. It usually takes several months for people to come out of a coma. During this time, they regain consciousness and respond to what is happening. After another short period, the person can fully recover their cognitive abilities. […] Recovery from a coma can sometimes be discouraging. But with proper care and support, patients can make significant progress. And very soon, patients will be able to return to everyday life.

• #36 MEDICALLY INDUCED COMA: WHAT IT IS, HOW IT WORKS, WHO BENEFITS, AND RECOVERY OUTCOMES | Mya Care

  https://myacare.com/blog/medically-induced-coma-what-it-is-how-it-works-who-benefits-and-recovery-outcomes

  A medically induced coma is a reversible state of deep unresponsiveness that is brought about by sedative administration in an attempt to protect the brain from traumatic damage. The sedatives trigger unconsciousness by suppressing various aspects of brain activity. This helps to lessen the energy requirements of the brain that would otherwise be used to sustain conscious arousal, enabling it to spend more energy on regeneration. […] There are varying degrees of unresponsiveness that a person in a coma may experience. Doctors use the Glasgow Coma Scale to assess a patients level of consciousness. […] It is usual for a person in a coma to lose their cognitive abilities yet to retain normal sleep patterns and brain activity pertaining to vital functions required for their survival, such as maintaining their heartbeat.

• #36 MEDICALLY INDUCED COMA: WHAT IT IS, HOW IT WORKS, WHO BENEFITS, AND RECOVERY OUTCOMES | Mya Care

  https://myacare.com/blog/medically-induced-coma-what-it-is-how-it-works-who-benefits-and-recovery-outcomes

  A medically induced coma is often only used as a last, life-saving resort in the emergency ward of the hospital. A coma is medically induced to protect brain function in cases of traumatic injury. […] Recovery from a coma depends on the areas of the brain that are affected and how well the brain manages to prevent secondary injury as a result of prolonged faulty brain energy metabolism. […] The chances of coming out of medically induced comas are quite high compared to natural comas, as they are reversible. They usually only last for 1-2 days. The prognosis worsens substantially after 4-6 days, yet some patients are still able to recover even after 6 months. […] If the coma lasts for weeks to months, the patient may suffer from lifelong disability, be in a permanent vegetative state or pass away. Risk factors for longer coma durations include older age, kidney insufficiency, and systemic shock. […] The best prognosis has been seen in using hypothermia and when treating status epilepticus with a drug-induced coma.

Zobacz więcej