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
Brain death is not the same as coma, because someone in a coma is unconscious but still alive. Brain death occurs when a critically ill patient dies sometime after being placed on life support. This situation can occur after, for example, a heart attack or stroke.
Brain death is often confused with other conditions that seem similar, such as coma and vegetative state. Brain death: Irreversible cessation of all functions of the entire brain, including the brain stem.
This means they will not regain consciousness or be able to breathe without support. A person who is brain dead is legally confirmed as dead. They have no chance of recovery because their body is unable to survive without artificial life support.
But without a ventilator to keep blood and oxygen moving, this beating would stop very quickly, usually in less than an hour, Greene-Chandos said. With just a ventilator, some biological processes — including kidney and gastric functions — can continue for about a week, Greene-Chandos said.
Typically, a coma does not last more than a few days or couple of weeks. In some rare cases, a person might stay in a coma for several weeks, months or even years. Depending on what caused the person to go into a coma, some patients are able to return to their normal lives after leaving the hospital.
Severe brain injury is usually defined as being a condition where the patient has been in an unconscious state for 6 hours or more, or a post-traumatic amnesia of 24 hours or more. These patients are likely to be hospitalised and receive rehabilitation once the acute phase has passed.
Recovery from coma is a gradual process, starting with the person's eyes opening, then responding to pain, and then responding to speech.
Does a medically induced coma mean death? No. A person in a medically induced coma is unconscious and does not react to external stimuli, such as light, sound, or touch. However, the brain may process stimuli to certain level, but the person cannot wake up to it.
Cerebral angiography: Four-vessel angiography is the gold standard for tests evaluating cerebral blood flow. It can confirm brain death when it shows cessation of blood flow to the brain.
Variability in the diagnosis of brain death has the potential to lead to misdiagnosis. Even in the clearest circumstances, families may have difficulty accepting a diagnosis of brain death when they see their loved one's heart still beating and feel their body warm to the touch.
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.
After the first clinical exam, the patient should be observed for a defined period of time for clinical manifestations that are inconsistent with the diagnosis of brain death. Most experts agree that a 6 hour observation period is sufficient and reasonable in adults and children over the age of 1 year.
Since the body of a brain dead person can still have a heartbeat, can still produce urine, and can still accomplish oxygen exchange with the help of a breathing machine, those who have not dealt with brain death may conclude that at least a part of the patient is still alive and perhaps the other parts are on the mend ...
Annie Shapiro (1913–2003) was a Canadian apron shop owner who was in a coma for 29 years because of a massive stroke and suddenly awakened in 1992. Apart from the patients in the true story Awakenings, Shapiro was the longest a person has been in a coma like state and woken up.
The length of time a patient is in a medically induced coma is "largely dependent on the disease that you're treating," Souter said. In most cases, a coma is induced for a few days up to two weeks; induced comas longer than a month are extremely rare.
Studies show a very high overall mortality, ranging between 76% and 89%. 5, 6, 7 Of the surviving patients, only very few recover to a good outcome. The majority of the survivors do so with permanent disorders of consciousness or severe disabilities (see Table 1).
An individual with post-coma unresponsiveness has regained a normal sleep/wake cycle and should be able to open and close their eyes, as well as react to loud noises. While these may appear to be signs of consciousness, they are actually the result of involuntary, autonomic responses.
Some patients awaken from coma (that is, open the eyes) but remain unresponsive (that is, only showing reflex movements without response to command). This syndrome has been coined vegetative state.
Stage 3: Agitation and confusion:
Now, the patient might start responding more regularly. They may need help remembering recent events and may be disoriented about their current location. The patient could display various behavioural difficulties, including outbursts, swearing, biting, or physical aggressiveness.
Coma with eye-opening may occur with supratentorial, infratentorial, or global brain insults of various etiologies (e.g., stroke, anoxia). Brainstem involvement either as primary injury or secondary injury due to herniation appears to be a commonality among patients with eyes-open coma.
A vegetative state is similar to a coma but isn't the same. People in a vegetative state have recovered enough that they aren't in a coma, but their brain's abilities and activity are still very limited. The potential for recovery from a vegetative state varies widely.
Unsourced material may be challenged and removed. Elaine Esposito (December 3, 1934 – November 25, 1978) held the record for the longest period of time in a coma according to Guinness World Records, having lost consciousness in 1941 and eventually dying in that condition more than 37 years later.
Other studies have shown that up to 20 percent of patients in various vegetative states can hear and respond on at least some level. But at least some of the responses seen could be dismissed as simple reflexes, or at best akin to someone in a dream state responding to stimuli.