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Coma After Stroke: What Causes It, and What Are the Chances of Waking Up?

woman sitting next to hospital bed with husband in coma after stroke

Watching someone that has fallen into coma after stroke can be frightening because it’s often unknown if or when they will wake up.

To help you through this tough time, we’ll share some statistics and stories about coma after stroke.

What Is a Coma?

When someone goes into a coma, the person enters a prolonged state of unconsciousness. They are alive but unresponsive to their environment and cannot be awakened, even by pain. Interestingly, there’s a chance that they can hear — but they cannot respond.

What Causes Coma After Stroke?

To understand why someone has fallen into coma after stroke, it’s important to know what causes a stroke to begin with.

A stroke occurs when the supply of blood to the brain is compromised. This can result from a blocked/clogged artery, known as ischemic stroke, or burst artery, known as hemorrhagic stroke.

The disturbance in the brain during stroke can increase intracranial pressure, cause loss of oxygen, and start a buildup of toxins, which can all lead to a stroke-induced coma.

Swelling in the brain, or cerebral edema, in particular is thought to increase the risk of coma after stroke.

What Types of Stroke Lead to Coma?

Every stroke is different, which means that every stroke will lead to different outcomes.

It’s generally understood that coma is more common after a massive stroke or stroke in the brain stem.

The brain stem houses the Reticular Activating System (RAS) which controls the arousal states of waking and sleeping.

According to Dr. Alejandro Rabinstein, when the RAS is damaged by stroke, it can lead to coma.

This does not mean that only massive stroke and brain stem stroke can lead to coma, but these types of stroke carry a higher risk.

How long can a person be unresponsive after a stroke?

It’s unknown how long a stroke-induced coma will last in any patient since every stroke is different.

Statistically, when stroke-induced coma leads to death, it usually happens within 4.5 days. However, in the extremes, some deaths happen after 1 day, and some happen after 105 days.

Although the statistics are grim, many patients wake up from coma after stroke! They could wake up quickly, or it may take time. We once heard about a patient waking up from a stroke-induced coma after 45 days.

While it can be distressing to wait that long for a loved one to wake up from coma, it shows that there’s hope even in seemingly grim situations.

What can I do to help my loved one in a stroke-induced coma?

If your loved one has fallen into coma after stroke, talk to them.

It’s possible that someone in a coma can still hear, so talk to your loved one and speak words of encouragement.

While it’s not guaranteed that they can hear you, it’s worth the effort in the chance that they do hear you. Plus, it can also be therapeutic to you.

What can I do if they wake up?

If your loved one wakes up from a stroke-induced coma, congratulations! That deserves a huge celebration.

After they regain consciousness, it’s time to prepare for the long road to recovery ahead. If your loved one has sustained post-stroke paralysis, start rehabilitation as soon as possible.

Recovery can be intensive after massive stroke or brain stem stroke because the post-stroke side effects are often severe.

However, if your loved one woke up from their coma, then (s)he must be a fighter! It’s important to keep fighting during recovery to regain lost skills and improve chances of a good life after stroke.

Never give up hope.

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