The brain provides a clear consciousness. If this falls short due to, for example, a lack of oxygen or glucose, the brain cells cannot function properly and unconsciousness can occur. Unconsciousness can indicate a serious illness, but this is not always the case.

What is unconscious

  • Unconscious : the patient does not respond to speech, painful stimuli or shaking.
  • Decreased consciousness : the patient responds to speech through movements to speech, eye movements, opens the eyes and can be woken up, but responds drowsily and absently.
  • Coma : the patient is unconscious for a long time and cannot be woken.
  • Faintness : these are the short-term fainting spells or fainting spells.

The blood circulation ensures sufficient oxygen to the brain. The brain needs one fifth of the inhaled oxygen to function. There is no possibility in the brain to store extra oxygen. So if the oxygen supply to the brain is blocked, unconsciousness occurs within ten to twenty seconds.

Fainting (syncope, collapse)

Fainting has many causes and is usually harmless, although it does cause a lot of anxiety for the patient.
Causes of fainting include:

  • to startle
  • fear
  • seeing blood
  • getting an injection
  • hot and stuffy environment

With all these causes, the blood vessels in the abdomen open wide and the blood sinks, as it were. Patients become light-headed, have blurred vision, sigh, perspire or look pale and may suddenly collapse. These fainting spells usually last no more than a few seconds and are harmless.

Sudden unconsciousness due to circulatory arrest

Ventricular fibrillation can occur due to cardiac arrest. In ventricular fibrillation, the blood circulation comes to a standstill. In this way, the brain no longer receives oxygen and unconsciousness occurs. This happens so quickly that the patient is often unable to say anything because breathing is also controlled by the brain. This is a serious emergency because brain damage can occur after four minutes of circulatory arrest.

Faintness in the elderly

Older people who take medication for high blood pressure can also cause their blood vessels to open wider. When these people stand up, the blood also sinks, as it were, and a short-term fainting spell may occur. Here too, the blood supply to the brain is inadequate. A few seconds after getting up, patients become light-headed, dizzy and briefly unconscious. This is called orthostatic hypotension: low blood pressure due to standing upright. Patients who suffer from this should remember to get up slowly from a sitting or lying position. When getting up, they can hold on better until the dizziness passes before they start walking.

Heart block

Sometimes a short-term heart block occurs in older people. This causes the blood circulation to stagnate for a moment and the patient becomes unconscious for a short time. The patient usually comes to within a minute with a red face. This is called an Adam-Stokes attack and can occur very suddenly and unexpectedly.

Unconsciousness immediately after an accident

In an accident, we only speak of a concussion if the patient has been unconscious due to a hard blow to the head and has memory loss. If the unconsciousness lasts no longer than fifteen minutes, we call it a mild concussion; the patient usually cannot remember what happened. This gap in memory should not be larger than an hour. Symptoms such as headache, nausea and dizziness may also occur. Most of these symptoms disappear within three days and the patient must take it easy for a few days.
If the unconsciousness lasts longer than fifteen minutes, or the gap in memory is larger than an hour, this is a serious concussion. This may involve brain damage and the patient must in any case be seen by a doctor.

Unconsciousness several hours after an accident

A hard blow to the head can cause a blood vessel in the brain to rupture and slowly leak blood. The blood has nowhere to go in the brain and can lead to unconsciousness after a few hours because other parts of the brain and blood vessels are pinched. For this reason, wake-up advice is always given for 24 hours after a blow to the head and the patient is not allowed to be left alone. If the patient cannot be woken up, he or she must be sent in urgently. This does not always have to happen after a hard blow to the head, people who use blood-thinning medications are also at increased risk of this.

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