The 6 Levels Of Loss Of Consciousness And Associated Disorders
There is a wide variety of pathologies that can arise from an injury to the human brain. One of the effects that these disorders can have is decreased level of consciousness.
We’ll see now the different degrees to which a person can lose consciousness due to a pathology, and why this is believed to occur. However, before talking about this type of decrease and therefore the appearance of disorders, it is worth establishing what we mean by consciousness.
The ability that allows us to obtain knowledge of ourselves and the environment that surrounds us is called consciousness. And the degree that a person may have of it will be determined by what a neuronal system known as the reticular formation does or does not do, which is distributed throughout the brain stem, the diencephalon and the cerebral hemispheres.
Through the Ascending Reticular Activating System (SARA), The reticular formation controls the activity of cortical and thalamic neurons this being the key to wakefulness (being awake), all thanks to the bidirectional stimulation between the cortical and reticular areas.
Levels of loss of consciousness
There are different phases regarding loss of consciousness, some of greater fatality than others. Let’s review them:
1. Confusion
In this phase the damage is relatively minor although despite this the person cannot reason quickly and clearly and thinking is slow.
In this state the person is drowsy, and even falls asleep, even if it is not the right time or place. When she is awake she is unable to remain alert, and her movements are greatly restricted. Yes, it can be awakened when coming into contact with stimuli, and it is capable of reacting to verbal or painful stimulation.
3. Stupor or semi coma
Here the individual affected by the accident or pathology He can only wake up if he is presented with repetitive and intense stimuli, but the responses it produces will be inconsistent and slow. When encountering painful stimuli, they cope by avoiding them. There is no sphincter control and motor activity is null.
4. The coma
Etymologically, coma means deep sleep. It is a pathological state that presents a great loss at the level of consciousness, it is identified as a stage in which the individual cannot feel or wake up, does not produce any verbal or motor response to external stimuli, no matter how penetrating and painful they may be.
It should be noted that, in coma, which causes loss of consciousness is a result of no blood supply to the brain for 20 or more seconds, or when blood perfusion is below 35ml/minute per 100 grams of brain mass. A state of physiological savings is entered, so the brain seeks to reduce energy consumption (use less glucose, for example) in order to avoid further damage to brain cells.
5. Brain death
It is the last phase with respect to loss of consciousness, in this case there is no record of brain activity nor in the brain stem, since there is a global infarction and total paralysis of cerebral blood flow. Breathing is suspended (apnea), and can only be maintained by artificial means.
These types of disorders can arise for many different reasons. For example, as a result of a traumatic brain injury, vascular disorder, brain tumor, epilepsy, excessive alcohol consumption and a very long etcetera.
Fundamentally, any illness or accident with the potential to damage the diencephalon or brainstem is likely to result in coma or brain death, while less severe degrees of loss of consciousness can be produced by more superficial injuries.
Some patients remain in a coma for weeks, months, or even years, and enter in a state known as the vegetative state which is characterized by the fact that autonomic functions such as heart rate, breathing, temperature regulation and blood pressure are preserved, but reasoning, behavior or voluntary interaction with the outside is not.
