About Comas and Brain Injury

Simply put, comas are a period of unconsciousness following a severe brain injury. Unfortunately, there is nothing simply about them.

We know that during comas, the brain seems to have very little activity, and the little activity that it does have seems to be in control of basic functioning, such as heartrate, body temperature, and blood pressure.

The duration of a coma is largely determined by the type and severity of trauma to the brain and other parts of the body. Generally, when the length of a coma is 20 minutes or less, a mild brain injury has occured. Comas lasting longer than 20 minutes but less than 6 hours may preclude a diagnosis of moderate brain injury. A coma that lasts for more than 6 hours usually indicates severe injury to the brain.

The Stages of Coma

Comas are medically complicated states that are broken up into two phases and many subphase. The first phase is often referred to as deep coma. In a deep coma, patients are unable to engage in any voluntary action, such as opening their eyes or speaking. In severe cases, even the most primary responses, like responding to pain or gag reflexes, may be absent.

The second phase of coma is commonly called a vegetative state, or a minimally conscious state. Individuals at this stage may be able to open their eyes and mouth, or even more their limbs, but they cannot do so on command. While the patient is arousable, there is no ability to communicate at this phase. Patients who are able to communicate minimally but have no range of motion are often diagnosed as "locked-in," unlike patients who recover their communication abilities and develop a range of motion.

The most common instrument used for determining coma severity is called the Glasgow Coma Scale, which scores individuals on a scale of 1 to 15, with a lower score indicating a greater severity of injury.

Treatment & Rehabilitation

While there are many schools of thought on treatment issues regarding coma therapies, the reality is that there is care for people in comas. Some individuals may be strong candidates for coma stimulation therapy, which is determined by various clinical measures, such as levels of arousal, attention, and cognition.

As patients emerge from a coma, they may receive a variety of care depending on their funtioning, from speech therapy for swallowing problems, to range-of-motion exercises for physical rehabilitation. Once a person is deemed medically stable and their level of arousal and attention have increased, they are likely to be strong candidates for post-acute brain injury rehabilitation.

At NRI, our intenseive neurobehavioral program encourages individuals to make gains in their recovery. By providing consistent treatment, we help brain injury survivors reclaim lives of greater independence. If you'd like to learn more about our services, we invite you to explore our website, or simply call us at 888-298-4673.

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