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Coma


Coma can be defined as a state of prolonged unconsciousness from which a person cannot be roused, or numerically categorised as a GCS score of <8.

Causes (all causes of coma require emergency assessment)

Trauma

  • ●

    Head injury (diffuse axonal injury)

  • ●

    Extradural haemorrhage ( Fig. 11 )

    Figure 11, CT of the head .

  • ●

    Subdural haemorrhage

Metabolic

  • ●

    Diabetic ketoacidosis

  • ●

    Hypoglycaemia

  • ●

    Hypothermia

  • ●

    Hyperglycaemia

  • ●

    Hyponatraemia

  • ●

    Hypernatraemia

Organ failure

  • ●

    Cardiac/circulatory failure

  • ●

    Respiratory failure

  • ●

    Liver failure (encephalopathy)

  • ●

    Renal failure (uraemic coma)

  • ●

    Hypothyroidism

Vascular

  • ●

    Ischaemic stroke

  • ●

    Subarachnoid haemorrhage

Infective

  • ●

    Meningitis

  • ●

    Encephalitis

  • ●

    Cerebral malaria in the developed world • (common in endemic areas)

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