Comas are one of the most questioned and misunderstood medical phenomena. People are intrigued by the strange situations that cause comas and maybe even more by the stories of people waking up from them. What happens to the brain in a coma? Why do people fall into comas and why are they sometimes put in them? The simple science and medicinal reasons behind comas can help to remove some of the confusion and mystery around this illness.
A coma is a persistent state of deep unconsciousness. People in comas are unable to respond to any external stimulus. The state is similar to deep sleep, but it is impossible to wake a person in a coma as you would wake a sleeping person. Even though the person is not aware, their body will typically perform vital actions such as breathing without conscious thought.
The causes of comas are vast. Sometimes, pre-existing medical conditions cause comas, including diabetes and severe infections. Often, however, comas are caused by a sudden event such as a brain injury in an accident or a stroke. Even healthy people can experience a traumatic injury and enter a coma. Severe damage to the cerebral hemisphere of the brain affects the organ's ability to send neural signals. This lack of signaling results in a coma.
Awareness in comas is hotly debated in the medical and ethical fields. Stories of people who were aware of sounds and voices while in a coma muddy the field and leave doctors unsure. For the most part, however, people in comas are not aware of anything happening around them. Some scientists perform brain scans to assess the level of consciousness and activity in the brains of comatose patients, but these methods are still in their early stages.
Comas typically last no more than two to five weeks. However, the probability of a person coming out of a coma decreases as the length of time spent in the coma increases. For example, by the time a person has spent three days in a coma, their chance of making a full recovery is as low as 7%. This number only decreases as time passes.
Because comas can be caused by numerous events such as overdoses, lack of oxygen to the brain, and injury, every treatment is different. The best way for doctors to treat a coma or bring a person out of one is to reverse the effects. If someone enters a coma because of a lack of oxygen to the brain, then doctors will supply oxygen to try to revive brain cells and prevent further damage. Medications can reverse the comatose effects of an overdose. Medical professionals understand the urgency of this situation: the sooner a person receives help, and the sooner the brain can return to normal function, the better the chances of a good recovery.
Because scientists are not sure about the level of consciousness during a coma, there are many unknown factors. Stories of people like Martin Pistorius, who went into a meningitis-induced coma when he was 12 and awoke 12 years later, further confuse doctors and astound people. Strangely, the bodies of people in comas can function normally; this is evidenced by situations such as the Arizonan woman who is in a coma but gave birth to a healthy child in January, 2019.
Brain death, vegetive states, and comas are not all the same thing. The phrases cannot be used interchangeably because they represent different amounts of brain activity. A person in a coma is in a state similar to sleep, while someone in a vegetative state is "awake" in a sense but unaware of their surroundings. They may open their eyes and move slightly, but they are not conscious. Brain death occurs when all brain function ceases, and there is no chance that they will recover. Life support is all that keeps a person who is brain-dead alive.
Sometimes, in severe cases, doctors will intentionally put a person into a coma. This is called a medically-induced coma and is achieved by drugs such as anesthetics. Since the coma is a sort of healing state, doctors will do this to prevent further injury and to give the brain a chance to recover. Unlike natural comas, however, medically induced comas can be reversed with minimal effects.
Doctors use various methods to attempt to revive a comatose person. First, they must determine the reason for the coma. Medications can be used to revive a person in a coma. Ironically, sleeping pills seem to have a positive effect on some comatose patients. Experts believe repeated stimulations and physical therapy can also keep the body fit and help the brain resume activity.
There have been times when long-term comatose patients show progress and even awaken miraculously. In April, 2019, a Saudi Arabian woman named Munira Abdullah awoke from a coma 27 years after experiencing a traumatic brain injury in a car accident. In 2003, Terry Wallace awoke from a coma after a car accident 19 years earlier. These situations, while rare, give hope to many families of comatose people.
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