Unconsciousness

Sudden unconsciousness is the most alarming symptom of illness. For those around the affected person, unconsciousness is a distressing sign that often triggers intense excitement and panic. The dramatic effect is greater when unconsciousness occurs abruptly, especially in young, previously healthy individuals, like a bolt from the blue.

Unconsciousness is not always a health- or life-threatening condition. Brief loss of consciousness is common and usually harmless, primarily caused by temporary disruptions in blood flow to the brain. However, prolonged or deep unconsciousness, where the person cannot be roused by any stimuli, is called a coma. The most dangerous state occurs when unconsciousness results from the cessation of heart function or breathing.

Unconsciousness due to stopped heart or breathing can occur suddenly in various situations, such as electric shock, drowning, choking, poisoning, or head injuries. In these cases, panic and lack of knowledge often prevent effective resuscitation efforts.

Unconsciousness often precedes death and is an expected, inevitable outcome of severe, incurable diseases. Unconsciousness occurs when the brain’s consciousness center is disrupted. The causes of such disruptions are numerous and varied.

The most common cause is a lack of oxygen to brain cells. Oxygen is critical for cell function, as energy from food is produced only with oxygen’s involvement.

Coma is a prolonged state of unconsciousness from which the person cannot be awakened. It occurs in many internal diseases, infections, poisonings, and severe head injuries. Coma is often the final stage preceding death in all diseases.

The most common comas result from brain changes, known as cerebral comas. The primary cause is a stroke (apoplexy), caused by a ruptured brain blood vessel leading to hemorrhage or a blocked vessel (embolism).

Brain hemorrhage causes sudden, severe unconsciousness, often with paralysis of one side of the body. Involuntary urination or defecation is common, and breathing is deep and slow. Brain injuries also cause cerebral comas. Prolonged deep unconsciousness results from brain damage, with accompanying symptoms depending on the affected brain area.

Comatose states from various poisons, especially carbon monoxide, are increasingly common. Carbon monoxide poisoning causes higher mortality than all other poisons combined. After nausea, headache, vomiting, and impaired movement, unconsciousness follows. The severity depends on both the gas concentration and exposure duration, with even low concentrations causing severe poisoning if exposure is prolonged.

Taking large doses of sedatives or tranquilizers can induce coma. Hundreds of such drugs exist, and they may be taken accidentally or intentionally in suicide attempts. Medications must be kept away from children and mentally impaired individuals. Young people may take pills to draw attention, often due to conflicts with parents, unfulfilled desires, marital issues, or school failures. An incorrect dose can have fatal consequences.

Many internal diseases can lead to prolonged unconsciousness. Diabetic patients may fall into a diabetic coma due to harmful substance buildup (e.g., acetone, acids), with a characteristic acetone or rotten fruit breath, dry skin, and deep, heavy breathing.

Coma can also result from a sudden drop in blood sugar (hypoglycemic coma). Symptoms preceding it include sweating, weakness, hunger, headache, and seizures. Causes include excessive insulin doses or fasting while taking insulin. Prolonged low blood sugar can cause severe brain damage. Low blood sugar also occurs in liver diseases, pancreatic tumors, intense physical exertion, or alcohol poisoning, especially in young children. Administering sugar directly into the blood can restore full consciousness within seconds.

The comatose state depends on the cause and the brain area affected. In some brain injuries, patients are completely immobile, unresponsive to stimuli, but have open eyes, indicating damage to the cerebral cortex, the most developed and sensitive brain part. The eyes wander aimlessly, possibly reacting to coarse stimuli with purposeless movements.

In other brain injuries, patients may track moving objects or turn their eyes toward sound sources. Such patients cannot swallow or control bodily functions, requiring feeding through blood or a stomach tube. These injuries occur when the brain lacks oxygen for too long, but not long enough to cause death. Some patients may survive for a decade or more.