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Coma

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  1. See also
    1. Level of Consciousness
    2. Altered Level of Consciousness
    3. Coma
  2. Pathophysiology
    1. Bilateral cortical disease
      1. Unilateral disease does not cause coma
      2. Metabolic and toxic derangements most common
      3. Focal Neurologic signs absent except in Hypoglycemia
    2. Suppression of Reticular Activating System (RAS)
      1. Supratentorial pressure
        1. Subdural Hematoma
        2. Epidural hematoma
        3. Intracranial Abscess
        4. Subarachnoid Hemorrhage
        5. Brain Tumor
      2. Infratentorial pressure
        1. Cerebellar hemorrhage
        2. Posterior fossa tumor
      3. Intrinsic brainstem lesion
        1. Traumatic pontine hemorrhage
        2. Hypertensive pontine hemorrhage
        3. Neurologic degenerative diseases
        4. Brainstem tumor
      4. Torque on brainstem from sudden head blow
  3. Prognosis
    1. Nontraumatic coma
      1. Persistent coma for 2 months(n=596)
        1. Mortality: 69% mortality
        2. With severe Disability: 20%
        3. Without severe Disability: 8%
      2. Mortality correlated with:
        1. Abnormal brain stem response
        2. Absent verbal response
        3. Absent withdrawal response to pain
        4. Creatinine > 1.5 mg/dl
        5. Age > 70 years
      3. Interpretation
        1. Four or more of above criteria: 96% mortality
    2. References
      1. Hamel (1995) JAMA 273:1842

comatose (C0009421)

Definition (MSH)A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION.
Definition (CSP)profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused; coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem.
ConceptsDisease or Syndrome (T047)
ICD9780.01
BasqueKOMA
DanishKoma
DutchComa
EnglishComa, Comas, comatose, Exanimation
FinnishKOOMA
FrenchComa
GermanBewusstlosigkeit/Koma
Hebrewtardemet
Hungariankoma
ItalianComa
NorwegianBEVISSTLOSHET/KOMA
PortugueseComa
Spanishcoma, exanimación, exanimacion
SwedishKOMA
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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