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Curious-Still t1_jc6e4at wrote

When you see signs of hypoxic brain injury on imaging or when multiple organs start to fail, then less likely. When you fully take them off the sedative and paralytic meds inducing the coma, but they don't show any non-reflexive neurological responses or if formal brain death exam is positive then unlikely

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Citrusssx t1_jc8o5kv wrote

Do you know any miracle cases where they woke up? And can you say what was so miraculous about the recovery

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riptaway t1_jc8s4zc wrote

There's always outliers. The one percent. But especially for catastrophic brain injury, you're really talking about a very small percentage

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aggasalk t1_jc5u01i wrote

coma prognosis is not good. see here under [Duration of coma] (https://jnnp.bmj.com/content/71/suppl_1/i20). of those who have survived a week in coma (a small minority), half are in a persistent vegetative state..

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SerialStateLineXer t1_jc65u3d wrote

OP asked about accident-induced coma, while this study specifically excludes trauma-induced comas, concentrating on comas arising from medical conditions like diabetes, heart attack, or stroke.

I looked around a bit, and while I wasn't able to find any relevant papers quite as explicit as this is one, from what I found it doesn't look like the odds of recovery from trauma-induced comas are much better, and they may be worse.

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Deej1387 t1_jc6f4ze wrote

This varies wildly depending on the type of trauma, location of damage, and the mechanism, how and what kind of damage occurred.

"Coma" is actually an annoying term, largely because it's super non-specific. It can range from completely unresponsive and brain-dead with few if any central nervous system brain functions and full life support requirements, to persistent vegetative state, where someone may open their eyes, breathe on their own, have reflexes, but otherwise never interact or have meaningful expressions.

"Waking up" is also not a super explicit term, either, because plenty of people open their eyes and are "awake", but after massive brain injuries and trauma, many never recover meaningful function, and simply have reflexive movements, don't track or respond to stimulus properly, etc. Are they truly "awake", or do their eyes just open?

We generally can give people a decent idea of what kind of function to expect after trauma-related swelling, inflammation, blood collection, etc., has receded and resolved, but that can take weeks to months, dependent on the injury. Running various tests like MRIs and CTs to see blood flow to the brain and areas of injury like infarcts or mechanical changes can give us better ideas of the extent of damage, but again, time can change some things and give better pictures.

Very obvious traumas we usually know within a few weeks whether someone will wake up, less time if other organs are involved and/or failing. Less obvious or extensive traumas.. Well, months, sometimes, and even then, the results are mixed, and some "wake-up" more so than others.

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HankScorpio-vs-World t1_jc6b4wk wrote

Friend of mine was in a cycle accident at speed was in a “trauma” coma for about six weeks is alive but suffered some brain damage, the brain is very plastic though and was able to re-learn some skills lost from the trauma.

I think the time before it’s likely they won’t ever awaken is very much dependent on the type of injury. The level of brain activity can be monitored in more detail these days and the amount of “activity” and whether it is increasing or decreasing plays a big part.

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UngiftigesReddit t1_jc7180x wrote

Afaik, that depends on how old the patient is. Chances go way down pretty quickly, but there have been near full recoveries surprisingly late. Read a particular case study of a young man with traumatic brain injury where the whole case study has you keep going "this man is so done for" and yet he advised the doctors on the final paper. Mental.

Here, found it: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902071/

Wouldn't want to be a doctor making such a grave call with such a lack of certainty. Hate idea of giving up on someone who would have made it, but also of keeping a family from moving on for so long for nothing at all, or a patient who won't ever progress beyond opening his eyes and flinching again. "Waking up" is a multistep process, and you can get stuck on any step of the ladder, incl. those where you are not conscious, or can't move. (Ideally, both together, being stuck on just one truly sucks. E.g. locked in syndrome. Or vegetative state patients who are not yet conscious, but start screaming and screaming.)

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