Development of Cerebral Failure

10:36 AM

Oppression of consciousness and weakening of reflexes (tendinous, periosteal, dermal and craniocerebral nerves) progresses until complete fading in accordance with the stage of coma. Youngest reflexes are subjected to comatose death first.

In case of absence of focal damage of the brain, deepening of coma is accompanied by bilateral pathological marks and their subsequuent loss. Narrowness is characteristic of focal brain damage. Meningeal marks - rigidity of occipital muscles that accompany defeat of cerebral environments, meningitis, meningocephalitis - also appear during cerebral edema and irritation of cerebral environments.

Development of cerebral failure with fading functioning of CNS results in various abnormalities of respiration, hypo- or hyper-ventilation and corresponding respiratory shifts of acid-alkaline condition. Strong disorders of hemodynamics usually occur in the terminal state.

Various clinical displays, rate of development, and anamnesis are rather specific for different variants of comas.

Clinical picture and coma depth

9:34 AM

In a clinical terms coma is turning off of consciousness with loss of self-perception and perception of environment. Loss of consciousness can habe different degrees according to which different medical terms can be applied:

· destemperment - aberration, “overcast of consciousness ”, deafenation;
· somnolence - sleepiness;
· sopor - unconsciousness, insensibility, pathological hibernation, a deeper kind of deafenation;
· coma - the deepest degree of cerebral failure.

As a rule, the first three variant are diagnosed as precoma. However, there are no pathogenetically proved and precisely outlined clinical differentiations of all four degrees of coma (they are mostly referred to different coma stages).

Consequently, the use of term "state of coma" is widely approved with no dependence on the degree of loss of consciousness. The state of coma can be estimated by a simple and still quite informative scale.

Coma: the definition

9:21 AM

Coma (koma) can be translated from the ancient Greek as "deep dream". According to the classical definition this term stands for the condition of deep oppression of functions of the central nervous system (CNS), followed by a complete loss of consciousness, loss of reaction on external stimuli and disorder regulation of vital functions of the body.

Taking into account, that coma is diagnosed even in case when CNS is oppressed not that severely, i.e. on the stage of coma development. Therefore, the most expedient way to define coma is the following:

Coma is the condition of cerebral failure that is characterized by abnormality of coordinating activity of CNS, autonomous functioning of separate systems that lose ability for self-regulation and homeostasis at the level of an integrated organism. Coma is clinically manifested by loss of consciousness, abnormality of motional, sensitive and somatic body functions, including those that are vital.