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Coma causes


A coma can be caused by a focal lesion supratentorial or infratentorial or by a diffuse pathology. Diffuse pathologies are the most common cause of coma, being responsibile for about 60% of the cases. They may or may not involve the whole metabolism, but affect a large part of the brain, while a focal injury affects only a small part. Common causes of coma that can be classified as diffuse patologies are: head trauma associated with an increased intracranial pressure; various toxins including poisons and alcohol. coma include barbiturates, opiate narcotics, sedatives, amphetamines, cocaine and aspirin; metabolic abnormalities that lead to either elevated or reduced glucose levels in the blood; liver or kidney failure; hypoxia poor oxygenation or an imbalance of electrolytes; central nervous system infections, such as meningitis and encephalitis; a subaracnoidal emorragy or seizure disorders. Focal supratentorial injuries account for of the cases, and can be of vascular nature or caused by expansive lesions, like neoplasia or hydrocephalus. Focal infratentorial lesions account for the remainingof comas, and can be of vascular nature, expansive or demyelinising lesions.

Psychiatric Causes
Some psychiatric disease at a first look can be mistookcoma or other neurological disease involving consciousness. Some schizophrenic and catatonic, along with extremely severe peak of major depression are responsibile for "comatose" behaviour.
A coma is a profound state of unconsciousness. Patients are alive but are unable to fully move or respond to their environment, if at all. There are several levels of coma and patients may, or may not, progress through them. responsiveness of the brain lessens as the coma deepens and when it becomes more profound, normal body reflexes are lost and the patient no. The chances of recovery depend on the severity of the underlying cause. It is unclear whether a deeper coma alone necessarily means 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.

Contrasts to other conditions
The difference between coma and stupor is that a patient with coma cannot give a suitable response to either noxious or verbal stimuli, whereas a patient in a stupor can give a rough response to a noxious stimulus.Coma is also to be distinguished from the persistent vegetative state which may follow it. This is a condition in which the individual has lost function and awareness of the environment but does have noncognitive function and a preserved sleep-wake cycle. Spontaneous movements may occur and the eyes may response to external stimuli, but the patient does not speak or obey commands. Patients in a vegetative state may appear somewhat normal and may occasionally grimace, cry, or laugh.Likewise, coma is not the same as brain the irreversible cessation of all brain activity. One can be in a coma but still exhibit spontaneous respiration; one who is brain-dead, by definition, cannot do so.

Coma outcome
The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage: outcomes range from recovery to death. People may emerge from a coma with a combination of physical, intellectual and psychological difficulties that need special attention. Recovery usually occurs gradually, with patients acquiring more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Gaining consciousness again is not instant: the first days, patients are only awake for a couple of minutes, then 15 minutes or so, 30 minutes etc. In Germany, Köln is used to quicken the awakening traject. In Belgium a project is set up to train dogs and cats's "sixth sense" to warn patients and medical staff someone is awake.

A coma rarely lasts more than 2 to 4 weeks. Many patients who have gone into a vegetative state go on to regain a degree of awareness. Others may remain in a vegetative state for years or even decades. Predicted chances of recovery are variable due to different techniques used to measure the extent of neurological damage. All the predictions are statistical rates with some level of chance for recovery present: this means that a person may recover from coma even if their chances were low, but does not mean that the medical prediction of their chances were inaccurate. Time is the best general predictor of a chance for recovery, with the chances for recovery is infection such as pneumonia. There have been controversies and legal cases over whether to keep comatose patients alive for long periods using life support equipment. One such case is that of Karen Ann Quinlan, who fell into a coma after ingesting alcohol and according to some sources sedative at a party in . Her parents, in opposition to the doctors caring for her, eventually won the legal right to have her removed from her ventilator. She was able to breathe on her own, and lived in a vegetative state until her death from pneumonia

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