I was able to figure why I got a stroke. It came from my mother, that is, Protein S and C deficiencies. Protein S and C deficiencies give a person blood clots, and I had a stroke with blood clots in every extremity.
But I recalled that one of my two sons said that I was in a medically-induced coma. Thus, the title on the blog post: How does a medically-induced coma [or any coma, for that matter] help with healing the brain?
Johns Hopkins had a lot to say. A coma give the brain time to heal until swelling and pressure, which can cut off blood flow to the brain, and the doctors wait until the swelling and pressure diminish.
It is a state of unconsciousness where a person is unresponsive and cannot be woken. Someone who is in a coma is unconscious and has minimal brain activity. They’re alive, but can’t be woken up and show no signs of being aware.
The person’s eyes will be closed. They won’t normally respond to sound or pain, or be able to communicate or move voluntarily. Additionally, a person in a coma fails to respond normally to painful stimuli, light, or sound, lacks a normal sleep-wake cycle, and does not initiate voluntary actions, being unable to consciously feel, speak, hear, or move.
Someone in a coma will also have very reduced basic reflexes such as coughing and swallowing. They may be able to breathe on their own, although some people require a machine to help them breathe.
A coma usually only lasts a few weeks, during which time the person may start to gradually wake up and gain consciousness, or move into a different state of unconsciousness called a vegetative state. Some people will make a full recovery and be completely unaffected by the coma.
Neurocritical Care Society, launched in 2019, under the title Curing Coma Campaign, is the first to name “coma” as a medical issue that is curable, bringing researchers from Johns Hopkins and around the world to improve understanding of the condition and as well as the outcomes of medically-induced comas or otherwise.Â
The annual World Coma Day comes every year, with members establishing new research on the topic of coma. Beth Slomine, co-director of the Center for Brain Injury Recovery at the Kennedy Krieger Institute, says that the campaign lines up to offer those individuals who have gone through coma can recover, and its medical professionals help to develop new discoveries and treatments.
“We think of coma,” Slomine says, “as part of a constellation of disordered states of consciousness. In this state, their hearts beat and they can breathe on their own, but they do not seem to respond to their environment.”
Slomine’s study in children with comas has found that recovery is possible, and more so than prior. Her team followed 37 children, ages 2 to 17, who had been admitted for inpatient rehabilitation with severe TBI in either a vegetative or minimally conscious state.
“The majority of these children regained consciousness by their one-year follow-up, with those in a minimally conscious state emerging earlier and recovering more than those in a vegetative state. But even after a year, some children continued to recover more function,” Slomine says, “showing the potential for ongoing improvement over time.”
Adults can recover, too, after medically-induced comas. A 2021 study of “484 adults with TBI found that about half of those with severe TBI and three-quarters of those with moderate TBI returned to functioning independently at home during the day after 12 months, suggesting that the severity of the injury does not necessarily mean a poor outcome.”
But there’s a cost involved. A 2010 estimate of the total lifetime cost of TBI in the U.S. was over $76.5 billion, and moderate and severe TBIs that required hospitalization made up 90% of the costs.
When researchers at Columbia University studied the electroencephalogram, commonly known as EEG, or brain activity scans, of 104 clinically unresponsive patients, “they found that 15% of these people showed brain activity when they were asked to do specific tasks like ‘wiggle your toes,’ even though there were no outward signs of response. These 15% were also more likely to recover than were those who did not have a response in brain activity.”
Then there’s NHS, Scotland’s national health information service. A coma can result from injury to the brain, unconscious, and has minimal brain activity. The person’s eyes will be closed and they’ll appear to be unresponsive to their environment. They won’t normally respond to sound or pain, or be able to communicate or move voluntarily.
Doctors in Scotland assess a person’s level of consciousness using a tool called the Glasgow Coma Scale. This level is monitored constantly for signs of improvement or deterioration. The Glasgow Coma Scale assesses three things:
- eye opening – a score of one means no eye opening, and four means opens eyes spontaneously
- verbal response to a command – a score of one means no response, and five means alert and talking
- voluntary movements in response to a command – a score of one means no response, and six means obeys commands
Most people in a coma will have a total score of 9 or less. That means a lower score may have experienced more severe brain injury and could be less likely to recover.
Scottish researchers found the time of being in a coma differs among individuals. Some people have enormous relief from coming out of a coma. Others feel they can remember events that happened around them while they were in a coma. Research has also suggested that stimulating the senses could possibly help a person recover from a coma.
The chances of someone recovering from a coma largely depend on the severity and cause of their brain injury, their age, and how long they’ve been in a coma. But it’s impossible to accurately predict whether the person will eventually recover, how long the coma will last, and whether they’ll have any long-term effects.
This from the website Scientific American, specifically What Is a Medically-Induced Coma? In traumatic brain injury—such as the bullet wound gotten by U.S. Rep. Gabrielle Giffords in an assault outside a Tucson supermarket that killed six people and wounded 13 others—doctors sometimes induce a coma.
What happens with a medically-induced coma is that you take a drug and administer it until you see a certain pattern in the monitor that follows the patient’s brain waves.
One researcher said, “Patients with brain injuries who are in a coma have a similar pattern. If that pattern is there, then you feel comfortable that the patient is in a drug-induced coma. You are doing it so that you can hopefully protect the brain.
“You may have areas without adequate blood flow. As the brain heals and the swelling goes down, maybe those areas that were injured can be protected. But the main thing about a drug [or medically] -induced coma, as opposed to a regular coma, is that it’s reversible. They would come right out of it once you removed the drugs.”
It depends on how the person is moving along and the cause of the injury. What the intensive care unit doctors do is try to have them come out as soon as possible–for example, from profound trauma or a stroke. Doctors who do this watching and monitoring make every effort to only employ this option for as long as they need to use it.
As Thomas Edison once said, “The chief function of the body is to carry the brain around.” And without a brain, what are we? I trust you know the answer.
