Good to know.
Loss of consciousness (fainting) is regarded as a pathological medical condition bordering sleep or coma. In both cases, the person that lost consciousness cannot be “screamed” or “reach out”. In fact, in this state, a person does not respond to external stimuli whatever their force is.
The cause of unconsciousness
Causes of losing consciousness are numerous, from psychological influence to a brain injury or stroke.
Neurophysiology of unconsciousness
Pathophysiological basis of unconsciousness is a severe disturbance of blood flow in the brain (actually acute impairment of blood flow), namely in its trunk, from where begins and spreads to the whole brain tissue including cerebral cortex, the reticular formation. This formation is like a battery, which feeds the brain with energy. Its role is clearly defined in the circadian rhythm (day / night) – with falling asleep it turns off and when awakening it switches on. The faster it works, the faster a person moves from one state to another. The reticular formation is as multiple net composed of nerve cells with spikes and doesn’t exist by itself, it has a clear interaction, including the vascular system, because their work has provided a sufficient amount of oxygen and glucose. Thus, the vascular link is the main pathological link for unconsciousness.
Pathogenesis of unconsciousness
The sharp decline of nutrients to the brain stem and reticular formation is due to the excessive expansion of arteries or with subsequent reductions in blood pressure (BP) (collapse status) to 50/60 Hg mm or a sharp narrowing of the arteries with normal blood pressure.
Restoration of blood flow in unconsciousness takes place relatively quickly and people can come to their senses slowly, feeling disorientation, weakness, nausea, tremor, and others.
Risks of unconsciousness.
- For a long time the state of unconsciousness (> 3 minutes) may lead to deeper, in some cases, organic changes in the brain. Ischemic mini stroke is forming in the brain tissue, which requires subsequent forced hospitalization in a specialized department.
- When it is latent convulsive readiness the unconsciousness deepens this pathology and can lead to epileptic attacks. And with chronic cardiovascular and other diseases it leads to disruption of the mechanisms of compensation, the critical state of coma.
- The repeated unconsciousness may damage interneuron connections of the brain reducing the number of synapses.
- In the fall there is a great risk of head injury, including brain damage of moderate or severe degree.
Morbidity of unconsciousness
In children and adolescents unconsciousness is caused by excessive sensitivity to external stimuli (psychological discomfort, blood type, stuffy room, heat). Some part of this age category with the labile higher nervous activity has imperfect mechanisms to protect from such an individual response. The vegetative nervous system of young people plays an important role who “executes” instruction of the subcortex without considering the importance of the stimulus and can accept a minor irritant as 100%. The vegetative nervous system sends a complete impulse to the arteries, which in 1-2 seconds leads to excessive expansion of the arteries and subsequent lowering of blood pressure.
In older people causes of unconsciousness differ a little. Loss of consciousness becomes depended from organic changes when spasm, narrowing or blockage of arteries dominates. Hypertensive heart disease, atherosclerotic plaque, arrhythmia, congenital malformations of the brain vessels, blood clotting, anemia, brain tumor, an overdose of drugs, chemicals, late debut epilepsy, arteritis, and others.
The consequences of unconsciousness
For young people there is a danger of so-called habitual unconsciousness. Its essence is not in desire or unwillingness of a man, but in physiological laws of the central nervous system, which “remembers” the fact of unconsciousness and repeats in similar provocative circumstances with fewer stimuli.
For older people the factor of fear and constant anxiety play the role because they realize the risk of an injury or death, any various diseases, aggravates or exacerbates chronic illnesses. Thus unconsciousness really launches a “sleeping” illness in people aged 40 to 60 years, a period of relative health.
When should I see a doctor?
With the first episode of unconsciousness you should visit a doctor (neurologist, therapist) to determine its causes. Call an ambulance and before its arrival to put the person in the horizontal position on the side that he could not injure, provide fresh air, reveal the collar, establish verbal contact.
What tests you have to pass in the loss of consciousness?
To exclude organic brain damage or other parts of the head – CT (computed tomography) or MRI (magnetic resonance imaging).
To find structural changes you should pass following a comprehensive survey which includes:
– ECG (electrocardiography with Cardiovisor);
– EEG (electroencephalography);
– Ultrasound doppler of blood vessels of the neck and head (USDG), endocrine gland and internal organs;
– VST (vascular screening technology = capillaroscopy);
– Review of neurologist and internist;
– Counsultation of a psychologist;
– If necessary blood tests, urinalysis, other clinical tests.
The examination should give a complete picture of the origin and nature of unconsciousness and choose the tactics of treatment and prevention of these conditions.
How to effectively treat unconsciousness?
The treatment depends on the primary cause, age, sex, character, temperament, concomitant diseases or organic and psychological complications. Treatment should be personalized, comprehensive (with an expert team) and with monitoring systems that are involved in this pathological condition.
The duration of treatment depends on the performance of previous surveys and the results of a hardware control.
Forecast in the loss of consciousness
Patients with loss of consciousness must be sure that it will not happen again. For the doctor it is important to bring cardiovascular, central nervous and other body systems in balance so that would be returned to all the body functions to so-called state of complete health when unconsciousness is not possible.