Coma

comatoseunresponsivecomatose statesemi-comatosea comachronic comacoma, post-head injuryComasdeep unconsciousnessloss of consciousness
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened; fails to respond normally to painful stimuli, light, or sound; lacks a normal wake-sleep cycle; and does not initiate voluntary actions.wikipedia
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Induced coma

medically induced comamedically-induced comaartificial coma
Comas can be derived by natural causes, or can be medically induced.
An induced coma, also known as a medically induced coma, a barbiturate-induced coma, or a 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.

Cerebral hypoxia

cerebral anoxiahypoxic ischemic encephalopathyhypoxic-ischemic encephalopathy
Oxygen deprivation in the brain, also known as hypoxia, causes sodium and calcium from outside of the neurons to decrease and intracellular calcium to increase, which harms neuron communication.
Continued oxygen deprivation results in fainting, long-term loss of consciousness, coma, seizures, cessation of brain stem reflexes, and brain death.

Glasgow Coma Scale

Glasgow Coma ScoreGCSGlasgow Coma Scale (GCS)
It can also be defined as a score of ≤ 8 on the Glasgow Coma Scale (GCS) lasting ≥ 6 hours.
The initial indication for use of the GCS was serial assessments of people with traumatic brain injury and coma for at least six hours in the neurosurgical ICU setting, though it is commonly used throughout hospital departments.

Reticular formation

reticular activating systemreticulospinal tractascending reticular activating system
From a neurological perspective, consciousness is maintained by the activation of the cerebral cortex—the gray matter that forms the outer layer of the brain and by the reticular activating system (RAS), a structure located within the brainstem.
Mass lesions in brainstem ARAS nuclei can cause severe alterations in level of consciousness (e.g., coma).

Subarachnoid hemorrhage

subarachnoid haemorrhagesubarachnoidsubarachnoid hemorrhage, traumatic
In contrast, coma resulting from a severe traumatic brain injury or subarachnoid hemorrhage can be instantaneous.
Confusion, decreased level of consciousness or coma may be present, as may neck stiffness and other signs of meningism.

Unconsciousness

unconsciousloss of consciousnessnarcosis
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened; fails to respond normally to painful stimuli, light, or sound; lacks a normal wake-sleep cycle; and does not initiate voluntary actions.

Altered level of consciousness

level of consciousnessaltered mental statusdecreased level of consciousness
In the initial assessment of coma, it is common to gauge the level of consciousness on the AVPU (alert, vocal stimuli, painful stimuli, unresponsive) scale by spontaneously exhibiting actions and, assessing the patient's response to vocal and painful stimuli.
Coma is the inability to make any purposeful response.

Electroencephalography

EEGelectroencephalogramelectroencephalograph
Special tests such as an EEG can also show a lot about the activity level of the cortex such as semantic processing, presence of seizures, and are important available tools not only for the assessment of the cortical activity but also for predicting the likelihood of the patient's awakening.
It is also used to diagnose sleep disorders, depth of anesthesia, coma, encephalopathies, and brain death.

Consciousness

consciousconsciouslyhuman consciousness
Wakefulness describes the quantitative degree of consciousness, whereas awareness relates to the qualitative aspects of the functions mediated by the cortex, including cognitive abilities such as attention, sensory perception, explicit memory, language, the execution of tasks, temporal and spatial orientation and reality judgment.
This category generally includes minimally conscious state and persistent vegetative state, but sometimes also includes the less severe locked-in syndrome and more severe chronic coma.

Abnormal posturing

Decerebrate posturingdecerebrate responsedecerebrate rigidity
Decorticate posturing is a stereotypical posturing in which the patient has arms flexed at the elbow, and arms adducted toward the body, with both legs extended.
Since posturing is an important indicator of the amount of damage that has occurred to the brain, it is used by medical professionals to measure the severity of a coma with the Glasgow Coma Scale (for adults) and the Pediatric Glasgow Coma Scale (for infants).

Thalamus

thalamicMetathalamusthalami
Arousal of the brain begins from the RF, through the thalamus, and then finally to the cerebral cortex.
Damage to the thalamus can lead to permanent coma.

Oropharyngeal airway

oropharyngealOPA
If the risk of asphyxiation is deemed high, doctors may use various devices (such as an oropharyngeal airway, nasopharyngeal airway or endotracheal tube) to safeguard the airway.
Oropharyngeal airways are indicated only in unconscious people, because of the likelihood that the device would stimulate a gag reflex in conscious or semi-conscious persons.

Human brain

brainbrain tissuebrains
Oxygen deprivation in the brain, also known as hypoxia, causes sodium and calcium from outside of the neurons to decrease and intracellular calcium to increase, which harms neuron communication.
This is characterised by coma, loss of reflexes, and apnoea, however, the declaration of brain death varies geographically and is not always accepted.

Hypoglycemia

low blood sugarhypoglycaemiahypoglycemic
For instance, severe hypoglycemia (low blood sugar) or hypercapnia (increased carbon dioxide levels in the blood) are examples of a metabolic diffuse neuronal dysfunction.
As blood glucose levels fall below 10 mg/dL (0.55 mM), most neurons become electrically silent and nonfunctional, resulting in coma.

Stroke

ischemic strokestrokescerebrovascular accident
An ischemic stroke, brain hemorrhage, or tumor may cause restriction of blood flow.
If the stroke is severe enough, or in a certain location such as parts of the brainstem, coma or death can result.

Rancho Los Amigos Scale

decreased cognitive functioning
The Rancho Los Amigos Scale is a 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.
The Rancho Los Amigos Scale (RLAS), a.k.a. the Rancho Los Amigos Levels of Cognitive Functioning Scale (LOCF) or Rancho Scale, is a medical scale used to assess individuals after a closed head injury, including traumatic brain injury, based on cognitive and behavioural presentations as they emerge from coma.

Corneal reflex

blink reflexcorneal
Assessment of the brainstem and cortical function through special reflex tests such as the oculocephalic reflex test (doll's eyes test), oculovestibular reflex test (cold caloric test), corneal reflex, and the gag reflex.
The examination of the corneal reflex is a part of some neurological exams, particularly when evaluating coma.

Tracheal intubation

endotracheal intubationintubationintubated
Stability of their respiration and circulation is sustained through the use of intubation, ventilation, administration of intravenous fluids or blood and other supportive care as needed.
When this becomes severe to the point of stupor or coma (defined as a score on the Glasgow Coma Scale of less than 8), dynamic collapse of the extrinsic muscles of the airway can obstruct the airway, impeding the free flow of air into the lungs.

Persistent vegetative state

vegetative statevegetativevegetable
After this time, some patients gradually come out of the coma, some progress to a vegetative state, and others die.
This condition differs from a coma: a coma is a state that lacks both awareness and wakefulness.

Reversal of Fortune

1990Reversal Fortunethe 1990 film
Dr. Wijdicks studied 30 films (made between 1970 and 2004) that portrayed actors in prolonged comas, and he concluded that only two films accurately depicted the state of a coma victim and the agony of waiting for a patient to awaken: Reversal of Fortune (1990) and The Dreamlife of Angels (1998).
It recounts the true story of the unexplained coma of socialite Sunny von Bülow, the subsequent attempted murder trial, and the eventual acquittal of her husband, Claus von Bülow, who had Dershowitz acting as his defense.

Brain damage

brain injurybrain injuriesbrain lesion
For example, after four months of coma caused by brain damage, the chance of partial recovery is less than 15%, and the chance of full recovery is very low.
The most severe cases result in coma or even persistent vegetative state.

Brain death

brain deadbrain-deadbraindead
It is also distinct from an ordinary coma, whether induced medically or caused by injury and/or illness, even if it is very deep, as long as some brain and bodily activity and function remains; and it is also not the same as the condition known as locked-in syndrome.

Coma scale

glasgow coma scale
A coma scale is a system to assess the severity of coma.

The Dreamlife of Angels

La Vie rêvée des angesThe Dream Life of Angels
Dr. Wijdicks studied 30 films (made between 1970 and 2004) that portrayed actors in prolonged comas, and he concluded that only two films accurately depicted the state of a coma victim and the agony of waiting for a patient to awaken: Reversal of Fortune (1990) and The Dreamlife of Angels (1998).
Marie lives in an apartment that she is looking after because the owners had a car accident in which everyone died, except for Sandrine, a teenager, who is in a coma.