The Many Possible Outcomes For A Coma Patient
There are several levels of coma, through which patients may or may not progress. As coma deepens, responsiveness of the brain lessens, normal reflexes are lost, and the patient no longer responds to pain. The chances of recovery depend on the severity of the underlying cause. A deeper coma alone does not necessarily mean a slimmer chance of recovery, because some people in deep coma recover well while others in a so-called milder coma sometimes fail to improve.
The outcome for coma and vegetative state depends on the cause, location, severity and extent of neurological damage: outcomes range from recovery to death. People may emerge from a coma with a combination of physical, intellectual and psychological difficulties that need special attention. Recovery usually occurs gradually, with patients acquiring more and more ability to respond. Some patients never progress beyond very basic responses, but many recover full awareness. Gaining consciousness again is not instant: in the first days, patients are only awake for a few minutes, and duration of time awake gradually increases.
Comas generally last a few days to a few weeks, and rarely last more than 2 to 4 weeks. After this time, some patients gradually come out of the coma, some progress to a vegetative state, and others die. Many patients who have gone into a vegetative state go on to regain a degree of awareness. Others may remain in a vegetative state for years or even decades. Predicted chances of recovery are variable due to different techniques used to measure the extent of neurological damage. All the predictions are statistical rates with some level of chance for recovery present: a person with a low chance of recovery may still awaken. Time is the best general predictor of a chance for recovery, with the chances for recovery after 3 months of brain damage induced coma being low (less than 10%), and full recovery being very low.
The most common cause of death for a person in a vegetative state is secondary infection such as pneumonia which can occur in patients who lie still for extended periods.
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