Coma is a state of deep suppression of functions of the central nervous system characterized by a complete loss of consciousness, loss of responses to external stimuli and impaired regulation of vital functions.

There is a variety of causes for coma development, but most commonly coma occurs due to circulatory disorders of the brain, traumatic brain injuries, inflammatory processes (e.g., meningitisencephalitissepsis), poisoning (with barbiturates, carbon monoxide, etc.), and due to hepatitis, diabetes, uremia. Patients in a coma state can have impaired blood supply to the brain and oxygen deprivation (hypoxia), abnormal acid-base balance and electrolyte metabolism, energy starvation of the nerve cells. The longer these factors affect the patient's brain, the more likely the patient is to lose basic brain functions, develop irreversible cognitive and motor disorders (парезов и paresis and paralysis). To treat comatose patients, the doctors of "" use the most advanced technologies, and therefore the risk of negative consequences for the body is significantly reduced. Also, neurorehabilitation helps to achieve the best possible recovery of brain functions lost due to a coma.

Vegetative state

vegetative state (VS), is a term that should be considered separately. It causes dysfunction of the cerebral cortex, while deep regions of the brain, such as hypothalamus and brainstem maintain their proper functioning. VS is also defined as the lack of possibility for spontaneous mental activity (lack of thinking processes) due to extensive damage or dysfunction of the cerebral hemispheres with the preservation of the activity of the diencephalic region and the brainstem retaining autonomic and motor reflexes, as well as the cycle of sleep and wakefulness. This means that the brainstem regulates the centers of the autonomic nervous system (respiratory center, cardiovascular regulation, rhythm - sleep - wakefulness and reflexes of chewing and swallowing). However, the patient’s conscious perception of the environment is impossible due to the damage to the cerebral cortex.

When giving a verdict of VS, doctors often deprive the patient and his/her relatives of the hope for recovery and doom them to a painful existence. However, the diagnosis of the vegetative state has a very complex set of clinical and instrumental methods, such as the study of brain electrophysiological activity, evoked potentials of the brain, positron emission tomography, tractography, as well as routine computer and nuclear magnetic resonance imaging techniques. Once all clinical and instrumental data have been summarized, one can suggest the development of VS.

Nonetheless, the studies at our clinic and data from the world literature show that eventually the results of examinations can be radically changed in patients with the obvious signs of the vegetative state and then the diagnosis of the vegetative state will become irrelevant. The patient begins to regain consciousness.

Once such example is a young man who has been transferred to us from Moscow. He had the following diagnosis: consequences of the traumatic brain injury that was suffered seven months ago, a vegetative state, extensive bedsores of the occipital region of the head, sacrum, heels, bilateral pneumonia, sepsis. The patient received artificial lung ventilation through a tracheal cannula. When the patient was admitted to our clinic and the whole complex of examinations has been completed, our specialists tended to think about the diagnosis of the vegetative state. However, the treatment of sepsis, pressure ulcers pneumonia and elimination of symptoms of intoxication contributed to the fact that the young man began to restore the functions of the cerebral cortex. Four months later after the admission to our clinic, the patient was discharged to continue treatment in his homeland. The patient underwent the removal of tracheostoma and could breathe on his own. Also, he could speak in simple phrases, ate with the mouth, swallowed well and did not choke. However, the patient has not fully recovered movements in the arms and legs due to the prolonged hypoxia of the cerebral cortex, and therefore he had to move around in a wheelchair.

To learn more about intensive care in the state of coma
please call us: +49 228 972 723 72
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