What is Coma or Comatose and What are its Types?

The prolonged unconsciousness state which is defined by the name coma or comatose can occur due to various problems such as a brain tumor, stroke, alcohol or drug intoxication, traumatic head injury, or an underlying illness, like an infection or diabetes.

Coma or comatose is a medical emergency which requires swift action to preserve brain function and life of the person. The cause of coma can be determined by a CT scan of the brain and a series of blood tests by which a proper treatment can be initiated.

The state of “coma or comatose” does last for longer period. The patients who last unconscious longer more than several weeks may be in the persistent vegetative state. If patients who are in the persistent vegetative state for almost more than a year have lower chances to awake from coma. A patient who is in coma is termed as being comatose.

Coma or Comatose may last from days to weeks. In severe condition coma may remain for more than five weeks, and sometimes may last long for several years. The condition of coma or comatose varies from patient to patient, some may recover some may not which reasons to death and in some cases they may also reach vegetative state.

Coma or comatose is the state of unconsciousness which is deep for a longer time. They can also be reclassified as permanent vegetative state when the period is longer. The person will not respond to sound, light or pain normally and they cannot be awakened – They cannot react to the environment surrounding.

Medically induced coma’s purpose is to make sure that the “control and protection of the brain’s pressure dynamics.” Brain swelling reasons high pressure which can starve oxygen in certain areas of the brain; brain tissue that is swollen can be injured by pushing against the interior of the skull. A medically induced coma or comatose can reduce the inflammation and swelling of the brain with the process that slows down the metabolism of the brain and reduces the brain’s electrical activity.

Persistent vegetative state (PVS) may occur, during or after a coma or comatose, a person will lose his cognition which leads to perform only some actions on his/her own that are involuntary. Some researchers explain the persistent vegetative state is a brain dead, even though the fact, the lower brain stem is fully functioning and healthy.

The person who is in coma or comatose persistent vegetative state (PVS) can perform the following:

• Move and blink their eyes
• Breathe naturally
• Cry or laugh (not a response to the events that happen externally.)
• Normal blood circulation
• Regular wake-sleep cycles
• Smile
• Movement in limbs
• Track objects using their eyes
• Open their eyes.

Oxygen starvation in brain reasons to brain death in coma or comatose patients. Medical diagnosis involves three things to need its presence: apnea, coma and cessation of brain activity permanently; or breathing artificially (not on their own). If a patient has the three signs then he/ she will not recover from this state or injury. The heart functions properly for brain dead patients which are known as alive on life support and removal of life support equipment leads to death in this case.

Coma or comatose is divided into many types and includes:

1. Toxic-Metabolic Encephalopathy: An acute condition of brain dysfunction that is reversible with the symptoms of delirium and/or confusion. There are various reasons for toxic-metabolic encephalopathy which includes organ failure, infection, systemic illness and other conditions which leads to this type of coma or comatose.
2. Brain Injury that is Anoxic: Complete lack of oxygen is the reason for anoxic brain injury in coma or comatose. Cell death in brain can happen in few minutes when there is lack of oxygen. It may lead from several conditions ranging from trauma or head injury, heart attack, poisoning or drug overdose, drowning.
3. Persistent Vegetative State (PVS) Coma or Comatose: Severe unconsciousness is reason in this state. Awareness of the surroundings cannot be identified and capability of voluntary movement is null. With a persistent vegetative state, a person doesn’t have a highly functional brain even with wakefulness. With this state, there is circulation, sleep-wake cycles, and breathing.
4. Locked-in Syndrome Type of Coma or Comatose: A rare neurological condition in which a person is completely paralyzed apart from the eye muscles, but has a normal brain with awareness and alert.
5. Brain Death: The cessation brain function is irreversible. Brain death may occur in coma or comatose due to any widespread or lasting brain injury.
6. Medical Induction: The unconsciousness in deep state or coma/ comatose that is temporary which is made to protect an injured brain from dying. Controlled dose of an aesthetic is given to the patient, which results in lack of awareness or feeling. The person’s vitals are closely reviewed by the doctor. This occurs only in ICU’s (Intensive Care Units).

Also Read:

• Treatment, Prognosis, Recovery Period of Coma or Comatose
• What Causes Coma or Comatose and What are its Symptoms?