Coma

A coma, sometimes also called persistent vegetative state, is a profound or deep state of unconsciousness. Persistent vegetative state is not brain-death. An individual in a state of coma is alive but unable to move or respond to his or her environment. Coma may occur as a complication of an underlying illness, or as a result of injuries, such as head trauma. . Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. Individuals may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands.

Treatment

Once an individual is out of immediate danger, the medical care team focuses on preventing infections and maintaining a healthy physical state. This will often include preventing pneumonia and bedsores and providing balanced nutrition. Physical therapy may also be used to prevent contractures (permanent muscular contractions) and deformities of the bones, joints, and muscles that would limit recovery for those who emerge from coma.

Prognosis

The outcome for coma and persistent vegetative state depends on the cause, severity, and site of neurological damage. Individuals may emerge from coma with a combination of physical, intellectual, and psychological difficulties that need special attention. Recovery usually occurs gradually, with some acquiring more and more ability to respond. Some individuals never progress beyond very basic responses, but many recover full awareness. Individuals recovering from coma require close medical supervision. A coma rarely lasts more than 2 to 4 weeks. Some patients may regain a degree of awareness after persistent vegetative state. Others may remain in that state for years or even decades. The most common cause of death for someone in a persistent vegetative state is infection, such as pneumonia.

Research

The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research related to coma in their laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Much of this research focuses on finding better ways to prevent and treat coma.

Organizations

Coma/Traumatic Brain Injury Recovery Association, Inc
Helps families of coma and head injury survivors by providing information and referrals, enabling them to make informed choices regarding treatment, rehabilitation and socialization alternatives as well as support from others who struggle with similar concerns.

8300 Republic Airport
Suite 106
Farmingdale, NY 11735
inquiry@comarecovery.org
Tel: Farmingdale
Fax: 631-756-1827

Brain Trauma Foundation
Nationwide organization devoted to improving the outcome of traumatic brain injury patients. Focuses on the acute phase of traumatic brain injury (TBI) and methods to improve chances of a meaningful recovery. The Foundation works to improve the care of TBI patients from the scene of injury to the emergency room and ICU through guidelines development, professional education, quality improvement, and clinical research.

1 Broadway
6th Floor
New York, NY 10004-1007
education@braintrauma.org
http://www.braintrauma.org
Tel: New York
Fax: 212-772-0357

Brain Injury Association of America, Inc.
Non-profit organization dedicated to people with brain injury and their families. Offers research, education, and advocacy programs through a national office, network of state affiliates, support groups, and a helpline.

1608 Spring Hill Rd
Suite 110
Vienna, VA 22182
braininjuryinfo@biausa.org
http://www.biausa.org
Tel: Vienna
Fax: 703-761-0755

Family Caregiver Alliance/ National Center on Caregiving
Supports and assists families and caregivers of adults with debilitating health conditions. Offers programs and consultation on caregiving issues at local, state, and national levels. Offers free publications and support online, including a national directory of publicly funded caregiver support programs.

785 Market St.
Suite 750
San Francisco, CA 94103
info@caregiver.org
http://www.caregiver.org
Tel: San Francisco
Fax: 415-434-3508

Content Provided By

NINDS Disorders is an index of neurological conditions provided by the National Institute of Neurological Disorders and Stroke. This valuable tool offers detailed descriptions, facts on treatment and prognosis, and patient organization contact information for over 500 identified neurological disorders.

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