In medical science, a coma is a state of profound unconsciousness in which a person is unresponsive to external stimuli and cannot be awakened. It is a severe neurological condition that can be caused by various factors, such as traumatic brain injury, stroke, lack of oxygen to the brain, metabolic disorders, infections, or drug overdose.
During a coma, the person is unable to consciously perceive their surroundings, speak, or move purposefully. However, basic life-support functions such as breathing and circulation are usually preserved. The level and depth of coma can vary, with some individuals showing minimal brain activity and others displaying some limited responses.
Comas can last for a short period or extend for an indefinite duration, depending on the underlying cause and the individual’s response to treatment. Medical professionals assess coma patients using standardized scales, such as the Glasgow Coma Scale, to evaluate their level of consciousness and neurological function.
Medical professionals monitor and assess comatose patients closely using various diagnostic tests, such as brain imaging, electroencephalography (EEG), and neurological examinations, to determine the cause and potential prognosis. Treatment aims to address the underlying condition, provide supportive care, and promote recovery if possible. However, the outcome of a coma can vary widely, from full recovery to long-term disabilities or even death.
Treatment of coma focuses on addressing the underlying cause, providing supportive care, and preventing complications such as infections, pressure sores, or blood clots. In some cases, medications or surgery may be necessary to reduce swelling or treat the underlying condition. Rehabilitation is often required for individuals who emerge from a coma to regain lost physical and cognitive functions.
Causes of Coma
Drug Poisoning:
Responsible for 40% of comatose conditions. Some drugs, when used under particular conditions, can harm or decrease synaptic functioning in the ascending reticular activating system (ARAS), preventing the system from effectively arousing the brain.
Drug side effects such as irregular heart rate and blood pressure, as well as excessive breathing and perspiration, may also indirectly damage ARAS function and lead to coma. Because that drug poisoning is the cause of a high proportion of comas, hospitals screen all comatose patients by watching pupil size and eye movement via the vestibular-ocular reflex.
Cardiac Arrest:
Lack of oxygen, which usually results from cardiac arrest, is the second most prevalent cause of coma, accounting for around 25% of cases.
The Central Nervous System (CNS) relies heavily on oxygen to power its neurons. Hypoxia, or a lack of oxygen in the brain, causes sodium and calcium from outside the neurons to drop and intracellular calcium to rise, compromising neuron communication.
In the brain, a lack of oxygen induces ATP fatigue, cellular breakdown due to cytoskeleton damage, and nitric oxide generation.
Stroke-Related Coma
A stroke-related coma accounts for 20% of all comatose states. Blood flow to a portion of the brain is limited or blocked during a stroke.
Blood flow may be restricted as a result of an ischemic stroke, a brain hemorrhage, or a tumor. A lack of circulation to brain cells prevents oxygen from reaching the neurons, causing them to become disturbed and die. When brain cells die, brain tissue deteriorates, potentially impairing function.
Other Biological Conditions:
Trauma, severe blood loss, starvation, hypothermia, hyperthermia, hyperammonemia, aberrant glucose levels, and a variety of other biological conditions account for the remaining 15% of comatose patients. Additionally, studies reveal that 1 in every 8 patients with severe brain damage goes into a coma.
A coma scale is a mechanism for determining the degree of coma.
Glasgow Coma Scale
The Glasgow Coma Scale is a neurological scale that tries to provide a reliable, objective manner of monitoring a person’s conscious state for both initial and ongoing assessment. The criteria of the scale are applied to a patient, and the resulting points give a patient score ranging from 3(Three) indicating profound unconsciousness to 14 (Fourteen). GCS was originally designed to determine the degree of consciousness following a head injury, but it is now used by first responders, EMS, and clinicians to assess all acute medical and trauma patients. It is also used in hospitals for chronic patient monitoring, such as critical care.
Longest Period of Time in Coma
The longest recorded coma in medical history lasted for 37 years. The patient, Terry Wallis, was involved in a car accident in 1984 at the age of 19 and remained in a coma until 2003. During that time, he was unresponsive and completely dependent on medical care.
In 2003, Terry unexpectedly regained consciousness and started to communicate with his family. Although he was still severely disabled and had limited cognitive abilities, his recovery was considered remarkable given the length of time he spent in a coma.
It’s important to note that Terry Wallis’s case is exceptional and not representative of typical comas. Coma duration varies widely among individuals, and most comas are of much shorter duration. Medical professionals continue to research and study comes to better understand their causes and potential treatments.
Elaine Esposito :
According to Guinness World Records, he held the record for the longest duration of time in a coma, having lost consciousness in 1941 and died in that state more than 37 years later. Edwarda O’Bara and Aruna Shanbaug later broke Esposito’s record for the longest comas.
She was rushed to a hospital at the age of six with a burst appendix and underwent an appendectomy on August 6, 1941. She never regained consciousness after being sedated. She fell into convulsions as the procedure was drawing to a conclusion, her fever soared to 107.6 °F (42.0 °C), and physicians thought she would not survive the night. The origin of the issue was contested, with some claiming Elaine had encephalitis and others claiming her brain did not receive enough oxygen during the procedure.
Her parents spent the first 10 months of her coma in a Chicago hospital until they could no longer afford her treatment, at which time they moved her home so her mother Lucy could care for her 24 hours a day, seven days a week.
Throughout her extended coma, she had periods of both deep slumber and open-eyed unconsciousness, and she gained only a few pounds, reaching 85 pounds (39 kg). Elaine has overcome a variety of different health issues throughout the years, including more stomach surgery, pneumonia, measles, and a collapsed lung. The family subsequently relocated to Tarpon Springs, Florida, and she was also flown to Lourdes, France, to pray for a miracle.
Elaine died at the age of 43 years and 357 days, having been in a coma for 37 years and 111 days.
Edwarda O’Bara :
After catching pneumonia in December 1969, he spent 42 years in a diabetic coma beginning in January 1970.
At the age of 16, O’Bara suffered pneumonia on December 20, 1969. Her condition deteriorated over the course of two weeks, and she was admitted to the hospital. According to her relatives, O’Bara “woke up shivering and in considerable pain because the oral type of insulin she had been taking wasn’t reaching her bloodstream” around 3 a.m. on January 3, 1970.
Her relatives hurried her to the hospital, where she succumbed to a diabetic coma. Edward begged her mother, Kaye O’Bara, not to leave her side before she slipped into a coma. She was fed by a tube, and Kaye repositioned her every two hours to prevent bedsores. Kaye also read to her, played music for her, and conversed with her. Joseph, her father, also quit his work to care for her. Kaye passed away in 2008, at the age of 81.
In conclusion, prolonged comas are rare and extraordinary medical conditions that challenge our understanding of the human brain and consciousness. The recorded cases of individuals who have spent extended periods in comas, such as Terry Wallis, Elaine Esposito, Edwarda O’Bara, and Sarah Scantlin, serve as remarkable examples of the resilience and unpredictability of the human body.
While the experience of individuals during a coma remains largely unknown, these cases highlight the potential for unexpected recoveries and the enduring dedication of caregivers. The medical community continues to explore the underlying causes and potential treatments for comas, seeking to improve our understanding and provide better care for affected individuals.
Though each coma case is unique, the stories of these individuals inspire hope and further our commitment to advancing medical research and support systems for those affected by coma. With ongoing research, continued advancements in medical technology, and dedicated healthcare professionals, we aim to improve outcomes and enhance the quality of life for individuals who experience prolonged comas.
Ultimately, the study of comas and their associated challenges fuels our collective pursuit of knowledge and pushes the boundaries of medical science, bringing us closer to unlocking the mysteries of consciousness and improving the lives of those affected by these profound states of unconsciousness.
Unveiling the Longest Recorded Coma in History: Extraordinary Cases of Prolonged Unconsciousness
In medical science, a coma is a state of profound unconsciousness in which a person is unresponsive to external stimuli and cannot be awakened. It is a severe neurological condition that can be caused by various factors, such as traumatic brain injury, stroke, lack of oxygen to the brain, metabolic disorders, infections, or drug overdose. […]