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Brain death and coma are two very different but clinically important conditions, which can usually arise after a serious trauma to the brain, such as after a serious accident, a fall from a height, stroke, tumors or overdose, for example.
Although the coma can progress to brain death, they are usually very different phases and affect the recovery of the person in a different way. In brain death, there is a definite loss of brain function and, therefore, recovery is not possible. The coma is a situation in which the patient maintains some level of brain activity, which can be detected on an electroencephalogram, and there is hope for recovery.
1. What is a coma
Coma is a state of profound loss of consciousness, in which the person does not wake up, but the brain continues to produce electrical signals that spread throughout the body and that maintain the most basic and important systems for survival, such as breathing or the response of eyes to light, for example.
Often, the coma is reversible and, therefore, the person can wake up again, however, the time until the coma passes is very variable, according to age, general health and the cause. There are even situations in which the coma is induced by doctors to increase the speed of recovery of the patient, as in the case of severe traumatic brain injuries.
A person who is in a coma is considered to be legally alive, regardless of the severity or duration of that condition.
What happens when the person is in a coma
When a person is in a coma, they need to be connected to breathing apparatus and their circulation, urine and feces are constantly monitored. The feeding is done through probes because the person does not show any reaction and therefore needs to stay in the hospital or at home, needing constant care.
2. What is brain death
Brain death happens when there is no longer any kind of electrical activity in the brain, although the heart keeps beating and the body can be kept alive with an artificial respirator and feeding directly through the vein.
Can the brain-dead person wake up again?
Cases of brain death are irreversible and, therefore, unlike coma, the person will no longer be able to wake up. For this reason, the brain-dead person is considered legally dead and the devices that keep the body alive can be turned off, especially if they are necessary for other cases where there is a chance of success.
How brain death is confirmed
Brain death needs to be confirmed by a doctor, after evaluating various types of involuntary bodily responses that assess the presence of brain activity. Thus, a person is considered brain dead when:
- He does not respond to simple orders like "open your eyes", "close your hand" or "wiggle a finger";
- The arms and legs do not react when they are moved;
- The pupils do not change in size with the presence of light;
- The eyes do not close when the eye is touched;
- There is no gag reflex;
- The person is not able to breathe without the help of machines.
In addition, other tests, such as an electroencephalogram, can be done to ensure that there is no electrical activity in the brain.
What to do in case of brain death
Upon receiving the news that the patient is brain dead, doctors generally question the victim's direct family if they authorize organ donation, provided that they are healthy and able to save other lives.
Some organs that can be donated in the event of brain death are the heart, kidneys, liver, lungs and the cornea of the eyes, for example. Since there are many patients waiting in line to receive an organ, the brain-dead patient's organs can contribute to treatment and even save another person's life in less than 24 hours.
Created by: Tua Saúde Editorial Team