Coma

Coma is an unconscious condition caused by impaired brain stem function.

Etiology: craniocerebral trauma, stroke, infection, epileptic status, brain tumors, exogenous intoxications, disorders of systemic metabolism (diabetes mellitus, hypoglycemia, uremia, eclampsia, thyrotoxicosis), etc. The decisive role in the development of coma is affected by the ascending activating systems of the brain stem And the interstitial brain.

Symptoms, course. Depending on the severity of the disturbance of vital functions, they are subdivided into several degrees. With mild coma, patients respond to painful stimuli; Reflexes from the nasal mucosa, corneal and pupillary; Sometimes tendon reflexes are preserved and Babinsky's symptom is evoked. Severe degree of coma: reaction only to intense pain stimuli, swallowing is disturbed, however, when food gets into the respiratory tract, a reflex cough arises; The respiration is stern, often according to the Cheyne-Stokes type. Deep coma: areflexia, atony, mydriasis, gross violations of breathing and circulation. Out-of-bound (terminal) coma: the vital activity of the patient is maintained only through the artificial ventilation of the lungs and the stimulation of the heart.

Treatment. When establishing the nature of coma - pathogenetic therapy. At all stages of a coma - a resuscitation.

The prognosis depends on the cause of coma and the severity of damage to the brainstem. With a deep coma, the prognosis is more often unfavorable; An absolutely unfavorable prognosis for an exorbitant coma.