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Friday, 16 May 2014

Coma - Ins & Outs.

'Coma' is a state of unresponsiveness, where affected person cannot be woken up, in response to various stimuli such as speaking, touching etc. Causes, diagnosis, treatment of Coma are as under:-

  • The common causes of coma can be related to brain diseases (due to head injury, brain stroke, brain fever, brain tumours, repeated fits etc.) and non-brain diseases wherein other parts of the body are affected initially and the brain is secondarily affected. Primary causes might include low sugar or sodium levels, kidney failure, liver failure, lack of oxygen supply to brain, drug over dosage or poisoning.

  • Hospitals follow some procedures in diagnosing the Coma. History taking such as duration of coma to know whether it was a sudden onset or any history of drug over dosage or poisoning.

  • As patient cannot obey / react to doctor's instructions, examination of eyes, eye movements, breathing pattern is one of the procedures in diagonizing Coma.

  • Coma can be detected through investigations like CT Scan of the brain, blood test, EEG, lumbar puncture to confim brain fever etc.

  • General treatments for 'Coma' include, maintenance of adequate oxygenation like use of mechanical ventilator, maintenance of blood pressure, correcting metabolic derangements such as low sugar or low sodium in the blood, providing adequate nutrition etc.

  • Some specific treatments include treatment of brain stroke, surgery to remove brain tumour and large blood clots.

  • The outcome in a patient with coma depends on several factors like underlying cause of come, duration of coma, the rapidity of starting treatment, the age of patient etc.

  • In case of severe head injury or large brain haemorrhage, many patients do not survive. But in case of patients with poisoning, drug over dosage, low sugar or low sodium levels, the outcome is good if the treatment is promptly started.

  • Younger patients tend to recover faster and do much better than those who are older in age.