Information about Coma
| ICD-10 | R40.2 |
|---|---|
| ICD-9 | 780.01 |
In medicine, a coma (from the Greek κῶμα koma, meaning deep sleep) is a profound state of unconsciousness. A comatose patient cannot be awakened, fails to respond normally to pain or light, does not have sleep-wake cycles, and does not take voluntary actions. Coma may result from a variety of conditions, including intoxication, metabolic abnormalities, central nervous system diseases, acute neurologic injuries such as stroke, and hypoxia. It may also be deliberately induced by pharmaceutical agents in order to preserve higher brain function following another form of brain trauma.
Severity
The severity of coma impairment is categorized into several levels. Patients may or may not progress through these levels. In the first level, the brain responsiveness lessens, normal reflexes are lost, the patient no longer responds to pain and cannot hear.Contrary to popular belief, a patient in a coma does not always lie still and quiet. They may talk, walk, and perform other functions that may sometimes appear to be conscious acts but are not.[1]
Two scales of measurement often used in TBI diagnosis to determine the level of coma are the Glasgow Coma Scale (GCS) and the Ranchos Los Amigos Scale (RLAS). The GCS is a simple 15-point scale used by medical professionals to assess severity of neurologic trauma, and establish a prognosis. The RLAS is a more complex scale that has eight separate levels, and is often used in the first few weeks or months of coma while the patient is under closer observation, and when shifts between levels are more frequent.
Outcome
Outcomes range from recovery to death. Comas generally last a few days to a few weeks, rarely more than 2 to 5 weeks. After this time, some patients gradually come out of the coma, some progress to a vegetative state, and others die. Some patients who have entered a vegetative state go on to regain a degree of awareness. Others remain in a vegetative state for years or even decades (the longest recorded period being 37 years). [2]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, because some people in deep coma recover well while others in a so-called milder coma sometimes fail to improve.
People may emerge from a coma with a combination of physical, intellectual and psychological difficulties that need special attention. Recovery usually occurs gradually — patients acquire more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Regaining consciousness is not instant: in the first days, patients are only awake for a few minutes, and duration of time awake gradually increases.
Predicted chances of recovery are variable owing to different techniques used to measure the extent of neurological damage. All the predictions are based on statistical rates with some level of chance for recovery present: a person with a low chance of recovery may still awaken. Time is the best general predictor of a chance of recovery: after 4 months of coma caused by brain damage, the chance of recovery is less than 15%, and of full recovery is very low. [3][4]
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.
Occasionally people come out of coma after long periods of time. After 19 years in a coma, Terry Wallis spontaneously began speaking and regained awareness of his surroundings. [5]
A brain-damaged man, trapped in a comalike state for six years, has recently been brought back to consciousness by doctors who planted electrodes deep inside his brain. The method, called deep-brain electrical stimulation (DBS) successfully roused communication, complex movement and eating ability in the 38-year-old American man who suffered a traumatic brain injury. His injuries left him in a 'minimally conscious state' (MCS), a condition akin to a coma but characterized by occasional, but brief, evidence of environmental and self-awareness that coma patients lack. If the researchers are able to replicate the results more widely, they may offer a glimmer of hope for people with all kinds of brain injury. [6]
See also
- Persistent vegetative state (vegetative coma), deep coma without detectable awareness
- Brain death (irreversible coma), irreversible end of all brain activity
References
- Sources consulted
- BIAUSA (Brain Injury Association of America), Types of Brain Injury.
- NINDS (National Institute of Neurological Diseases and Stroke), public domain information on TBI
- NINDS (National Institute of Neurological Diseases and Stroke), public domain information on coma
- Endnotes
1. ^ [1]
2. ^ According to the Guinness Book of Records, the longest period spent in coma was by Elaine Esposito. She did not wake up after being anaesthetized for an appendectomy on August 6, 1941, at age 6. She died on November 25 1978 at age 43 years 357 days, having been in a coma for 37 years 111 days.
3. ^ [2]
4. ^ [3]
5. ^ [4]
6. ^ "Electrodes stir man from six-year coma-like state", Cosmos Magazine, 02 August2007.2007">
2. ^ According to the Guinness Book of Records, the longest period spent in coma was by Elaine Esposito. She did not wake up after being anaesthetized for an appendectomy on August 6, 1941, at age 6. She died on November 25 1978 at age 43 years 357 days, having been in a coma for 37 years 111 days.
3. ^ [2]
4. ^ [3]
5. ^ [4]
6. ^ "Electrodes stir man from six-year coma-like state", Cosmos Magazine, 02 August2007.2007">
External links
- Waking coma patients with a sleeping pill
- Waiting.com - support group for coma patients' families
- Brain Injury Fact Sheets - Information on coma, and many other effects of brain injury.
- TBI Resource Guide Central source of information, services and products relating to brain injury, brain injury recovery, and post-acute rehabilitation.
The term symptom (from the Greek σύμπτωμα meaning 'chance', 'mishap' or 'casualty', itself derived from συμπιπτω
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Simply, a sign is an indication of some fact or quality; and, in everyday English, a medical sign is an "objective" indication of some medical fact or quality that is detected by a physician during a physical examination of a patient—such as elevated
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For other uses of "ICD", see ICD (disambiguation).
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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List of ICD-10 codes. The version for 2007 is available online at [1]
Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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For other uses of "ICD", see ICD (disambiguation).
The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.
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See also
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Medicine is the science and "" of maintaining and/or restoring human health through the study, diagnosis, and treatment of patients. The term is derived from the Latin ars medicina meaning the art of healing.
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Greek}}}
Writing system: Greek alphabet
Official status
Official language of: Greece
Cyprus
European Union
recognised as minority language in parts of:
European Union
Italy
Turkey
Regulated by:
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Writing system: Greek alphabet
Official status
Official language of: Greece
Cyprus
European Union
recognised as minority language in parts of:
European Union
Italy
Turkey
Regulated by:
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- See also Unconscious mind.
Unconsciousness, more appropriately referred to as loss of consciousness or lack of consciousness, is a dramatic alteration of mental state that involves complete or near-complete lack of responsiveness to people and
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Intoxication is the state of being affected by one or more psychoactive drugs. It can also refer to the effects caused by the ingestion of poison or by the overconsumption of normally harmless substances.
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Metabolism is the complete set of chemical reactions that occur in living cells. These processes are the basis of life, allowing cells to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories.
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Stroke
Classification & external resources
ICD-10 I 61. -I 64.
ICD-9 435 - 436
OMIM 601367
DiseasesDB 2247
MedlinePlus 000726pi
eMedicine neuro/9 emerg/558 emerg/557 pmr/187
MeSH D020521
Stroke (or
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Classification & external resources
ICD-10 I 61. -I 64.
ICD-9 435 - 436
OMIM 601367
DiseasesDB 2247
MedlinePlus 000726pi
eMedicine neuro/9 emerg/558 emerg/557 pmr/187
MeSH D020521
Stroke (or
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- For other uses of the term "hypoxia", see hypoxia.
Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply.
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A barbiturate-induced coma, or barb coma, is a temporary coma (a deep state of unconsciousness) brought on by a controlled dose of a barbiturate drug, usually pentobarbital or thiopental.
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MeSH D001930
Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage.
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Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage.
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The Glasgow Coma Scale is a neurological scale which aims to give a reliable, objective way of recording the conscious state of a person, for initial as well as continuing assessment.
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The Rancho Los Amigos Scale (a.k.a. the Rancho Los Amigos Cognitive Scale and the Rancho Scale) is a medical scale intended to assess the level of recovery of brain injury patients and those recovering from coma.
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Death is the permanent end of the life of a biological organism. Death may refer to the end of life as either an event or condition.[1] Many factors can cause or contribute to an organism's death, including predation, disease, habitat destruction, senescence,
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Persistent vegetative state
Classifications and external resources
ICD-10 R40.20 .
ICD-9 780.03
A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without
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Classifications and external resources
ICD-10 R40.20 .
ICD-9 780.03
A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without
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Statistics is a mathematical science pertaining to the collection, analysis, interpretation or explanation, and presentation of data. It is applicable to a wide variety of academic disciplines, from the physical and social sciences to the humanities.
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Brain damage or brain injury is the destruction or degeneration of brain cells.
Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis.
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Brain damage may occur due to a wide range of conditions, illnesses, injuries, and as a result of iatrogenesis.
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An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host's resources to multiply (usually at the expense of the host).
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Pneumonia
Classification & external resources
ICD-10 J 12. , J 13. , J 14. , J 15. , J 16. , J 17. , J 18. , P 23.
ICD-9 480 - 486 , 770.0
DiseasesDB 10166
eMedicine topic list
MeSH C08.381.
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Classification & external resources
ICD-10 J 12. , J 13. , J 14. , J 15. , J 16. , J 17. , J 18. , P 23.
ICD-9 480 - 486 , 770.0
DiseasesDB 10166
eMedicine topic list
MeSH C08.381.
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Terry Wallis (born 7 April, 1964) is an American man living in Arkansas who on June 11, 2003 regained awareness after spending almost 20 years in a minimally conscious state.
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A minimally conscious state (MCS) is a condition distinct from coma or the vegetative state, in which a patient exhibits deliberate, or cognitively mediated, behavior often enough, or consistently enough, for clinicians to be able to distinguish it from entirely unconscious,
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Persistent vegetative state
Classifications and external resources
ICD-10 R40.20 .
ICD-9 780.03
A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without
..... Click the link for more information.
Classifications and external resources
ICD-10 R40.20 .
ICD-9 780.03
A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without
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Brain death is a legal definition of death that emerged in the 1960's as a response to the ability to resuscitate individuals and mechanically keep the heart and lungs working. In simple terms, brain death is the irreversible end of all brain activity.
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Guinness World Records, known until 2000 as The Guinness Book of Records (and in previous U.S. editions The Guinness Book of World Records
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Elaine Esposito (December 3, 1934 - November 25, 1978) of Tarpon Springs, Florida, U.S., holds the record for longest coma.
Elaine never stirred after being anaesthetized for an appendectomy on August 6, 1941, when aged 6.
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Elaine never stirred after being anaesthetized for an appendectomy on August 6, 1941, when aged 6.
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Anesthesia or anaesthesia (see spelling differences; from Greek αν- an- “without” + αἲσθησις aisthesis
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