kõõma

Kóma, known in English as coma, is a prolonged state of unconsciousness in which a person cannot be awakened, does not respond to stimuli, and shows no purposeful movement. Reflexes may persist, and some patients may have sleep-wake cycles without awareness. Coma reflects severe disruption of brain function, often involving the cerebral cortex and brainstem, rather than a specific disease.

Causes are diverse and commonly include traumatic brain injury, stroke, oxygen deprivation, brain infections, tumors, metabolic or electrolyte disturbances, organ failure, and poisoning from drugs or toxins. Seizures and major surgeries can also be associated with coma. The underlying cause largely determines prognosis and treatment.

Diagnosis rests on timely stabilization of the patient and determination of the cause. The level of consciousness is commonly assessed with the Glasgow Coma Scale. Imaging, usually CT or MRI, helps identify structural injury. Laboratory tests assess metabolic problems, infections, and toxins. EEG may be used when seizures are suspected or brain activity needs evaluation. Clinicians distinguish coma from vegetative state and minimally conscious state; persistent coma beyond the acute phase has variable outcomes.

Management focuses on securing airway, breathing, and circulation, while treating the underlying cause. In intensive care, supportive measures prevent complications such as pneumonia, blood clots, ulcers, and malnutrition. Monitoring and rehabilitation planning are essential, as recovery ranges from full return of consciousness to various degrees of persistent disability.

Prognosis depends on cause, extent of brain injury, age, and duration of coma. Short, reversible comas carry better prospects; prolonged coma is often associated with poorer outcomes, though some patients regain substantial function.