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Q. A coma patient has normal vital signs with eyes shut even after surgery. Why?

Answered by
Dr. Prakashkumar P Bhatt
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Aug 27, 2019 and last reviewed on: Sep 16, 2020

Hello doctor,

A 55-year-old female is in coma. Her vital status are fine, but her eyes still shut, and head surgery completed 11 days back. Please help.

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Hello,

Welcome to icliniq.com.

She has significant brain insult in the form of left-sided brain infarct and left-sided brain blood clot or bleeding. She may need surgery to remove one part of the skull and preserve in the abdomen for future reimplantation. Consult a neurosurgeon for a decision about surgery. I want more details about her pupils and corneal reflex and breathing pattern. I think she must be on a ventilator, so monitor her properly, go for surgery if your surgeon says. Prognosis is not right if she recovers then also she will have weakness in right side and speech problems.

Thank you doctor,

She is not on a ventilator for the last six days. All vital status is stable. Surgery has been already completed before two weeks. Skull has been preserved in the stomach already. Pupils are fixes, eyes closed. And respiration is good.

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Hello,

Welcome back to icliniq.com.

Surgery completed 11 days ago. She is off ventilator now, her breathing is stable, that is a good thing, but still, pupils are fixed that is not a good sign. I will be to continue nursing care with physiotherapy, RT feeding, bedsore preventive care, and close neuromonitoring, and she will improve slowly and partially, a lot of patience and care are needed. If you have any particular question, please ask.

Thank you doctor,

But is there a count of the number of days that she will require? There has to be some science to reverse this disorder. Why the only answer comes as only time can tell, there has to be some treatment. Though eyes are closed, she is but blinking her right eyes more frequently now. And will she open eyes and will the pupils move?

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Hello,

Welcome back to icliniq.com.

I agree with you that science has been evolved over the period. But there is still some limitation, especially in neurological diseases like this case. A scientist can not reverse the neuron at present because neurons are the only tissue after the damage we cannot regenerate it back. But still, it is too early to comment on your patient. Wait for a month and quantify recovery, continue nursing care and treatment given by your neurologist.


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