A coma is a profound and prolonged state of unconsciousness that may be caused by a variety of medical problems including a traumatic head injury from a fall or motor vehicle accident. A brain hemorrhage, diabetes, stroke, hypoxia, and intoxication can also cause a coma.
Coma is not the same thing as a deep sleep because a comatose person cannot be awakened. He is not responsive to pain or light. Except for reflex movements, he cannot voluntarily move his limbs.
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To understand the comatose state, some knowledge of the brain’s anatomy is essential. The brain is an extremely complex structure. The right and left cerebral hemispheres are the two main parts of the brain, and they contain the frontal, parietal, temporal and occipital lobes of the brain. These lobes control movement, sensation, speech and thought. The cerebellum is located beneath the cerebral hemispheres and governs balance and coordination.
At the base of the brain lies the brain stem which regulates functions critical to life itself, like heart rate, blood pressure, and breathing. The reticular activating system (RAS) is situated in the brain stem and contains what might be called the brain’s “on/off” switch. The RAS plays a fundamental role in a person’s state of consciousness. If a person is awake, his RAS and at least one cerebral hemisphere are functioning. If and when he loses consciousness, one of two things has happened. His RAS has shut down or both cerebral hemispheres have ceased functioning.
Depending on the degree to which his brain still functions, a comatose patient may experience different levels of unconsciousness and unresponsiveness. In assessing a patient’s level of coma, physicians commonly rely on the following tests:
- AVPU scale
- Glasgow Coma Scale
- Ranchos Los Amigos Scale
- With the AVPU scale, the health care provider performing an evaluation determines coma level by looking first for signs of alertness, then for response to vocal stimuli (“Do you hear me?”), and finally for response to painful stimuli.
The Glasgow Coma Scale (GCS) provides health care providers with a way to measure the depth of a coma by quantifying a patient’s reactions with respect to eye opening, movement, and verbal response using a scale of 3 to 15. A normal person’s score is 15; the worst score is a 3.
The Ranchos Los Amigos Scale (RLAS) is a more complex scale with an assessment of eight different levels.
The prognosis for comatose patients is variable and differs according to the cause, location, severity and extent of neurological damage to the brain. Usually, a person will remain in a coma for a few days to a few weeks and then come out of the coma gradually. However, some patients progress to a vegetative state ; others die.
Once a person emerges from a coma, he may recover some or all of his former physical and intellectual abilities. Typically, the longer it takes for a person to emerge from a coma, the more likely it is he or she will have permanent residual effects.
Work with an Experienced Coma Attorney
Litigation in brain injury and coma cases is complicated. It takes a coordinated team approach on the part of the brain injury coma attorneys and staff to build a case that will lead to a favorable verdict. The Allen Law Firm has decades of experience: our coma lawyers routinely handle accident and injury lawsuits. Call 866-388-6412 for a free consultation.