What causes coma?Coma is the result of something that interferes with the functioning of the cerebral cortex and/or the functioning of the structures which make up the RAS. There are many things that can cause coma or other states of unconsciousness. In fact, a huge and varied number of conditions can result in coma. A good way of categorizing these conditions is to
consider the anatomic and the metabolic causes of coma. Anatomic causes of coma are those conditions that disrupt the normal physical architecture of the brain structures responsible for consciousness, either at the level of the cerebal cortex or the brainstem, while metabolic causes of coma consist of those conditions that change the chemical environment of the brain, thereby adversely affecting function.
There are many metabolic causes of coma, including: 1) A decrease in the delivery to the brain of substances necessary for appropriate brain functioning, such as oxygen, glucose (sugar), and sodium. 2) The presence of certain substances that disrupt the functioning of neurons. Drugs or alcohol in toxic quantities can result in neuronal dysfunction, as can substances normally found in the body, but that, due to some diseased state, accumulate at toxic levels. Accumulated substances that might cause coma include ammonia due to liver disease, ketones due to uncontrolled diabetes, or carbon dioxide due to a severe asthma attack. 3)The changes in chemical levels in the brain due to the electrical derangements caused by seizures.