Causes a Loss of Consciousness
Abnormal heart rhythms (heart beats too fast or too slow).
Syncope is caused by a temporary reduction in blood flow to
the brain. This temporary reduction in the blood supply in the
brain can be caused by heart diseases and, more commonly,
due to other conditions that do not directly involve the heart.
Non-cardiac causes
Vasovagal syncope. It is the most common cause. It is produced
by an involuntary reflex of the nervous system. The causes of
blackout are: after taking a blood sample; an intense pain, or
after certain situations, such as to urinate, defecate, or cough
intensely (situational syncope). This situation can also occur
with extreme emotional stress, hunger and thirst
Postural hypotension. It is the lowering of blood pressure due
to a change from one body position to a more vertical position,
after waking up or sitting down.
Dehydration. Causes a decrease in blood volume, and thus,
blood flow in the brain.
Blood pressure drugs. They can lead to an excessive lowering
of blood pressure at any time.
Diseases of the nerves of the legs in older people (especially
with diabetes or Parkinson’s disease). When there is a lack of
tonicity in the nerves of the legs, the blood does not return to the
brain adequately.
Stroke. Ischaemic stroke, cerebral stroke, transitory ischaemic
attack.
A migraine attack.
The lowering of sugar in the blood, or hypoglycaemia.
Alcohol consumption and abuse of other drugs.
Medical history
Friends, family, police, and witnesses, if appropriate, may be
asked:
whether the coma or symptoms beforehand started slowly or
suddenly
if the person had or appeared to have any vision problems,
dizziness, stupor or numbness before the coma
whether the patient has diabetes, any history of seizures or stroke,
or any other condition or disease
what medications or other substances the patient may have been
taken
Physical exam
The aim is to check the person’s reflexes, how they respond to
pain, and their pupil size. Tests may involve squirting very cold
or warm water into the ear canals.
These tests will trigger varying reflexive eye movements. The
type of response varies according to the cause of the coma.
Cardiac causes
Abnormalities of the heart valves (aortic stenosis or
pulmonary valve stenosis).
Disease of the aorta (aortic dissection due to aneurysms).
Disease of the heart muscle (cardiomyopathy).
Symptoms of Loss of Consciousness
Dizziness. Sensation that you are going to lose
consciousness within a few moments, including instability
of the body (cannot remain standing correctly).
Feeling of heat or a hot flush. At the beginning, a feeling of
intense heat may be noted, particularly, in the face and neck.
Blurred vision. It is a very common symptom just before
losing consciousness.
Cold sweats. It is a fairly common symptom.
Heaviness in the legs and difficulty in moving the body and
even to speak.
Confusion, bewilderment. Initially, they may note that they
do not know where they are, or what day, month, or time it
is, and that it is difficult to think lucidly.
Nausea, and sometimes vomiting, can accompany the
symptoms.
Diagnosis
A medical and recent history, blood tests, physical tests, and
imaging scans can help find out the cause of a coma, and
this helps decide which treatment to apply.
Blood tests
These will be taken to determine:
• blood count
• signs of carbon monoxide poisoning
• presence and levels of legal or illegal drugs or other
substances
• levels of electrolytes
• glucose levels
liver function
Lubar puncture (spinal tap)
This can check for any infection or disorder of the CNS. The
doctor inserts a needle into the patient’s spinal canal, measures
pressure, and extracts fluid to send for tests.
Imaging scans of the brain
These will help determine whether there is any brain injury or
damage, and where. A CT or CAT scan or an MRI will check for
blockages or other abnormalities. An electroencephalography
(EEG) will measure electrical activity within the brain.
Glasgow Coma Scale
Treatment

It is medical emergency. immediate survival

of the patient and securing their breathing and
circulation to maximize the amount of oxygen
that reaches the brain.
Administer glucose or antibiotics even before
the results of blood tests are ready, in case the
patient is in diabetic shock or has a brain
infection.
Treatment will depend on the underlying cause
of the coma