昏迷是最严重的意识障碍,即意识完全丧失,患者对机体内外环境的一切刺激均无反应。 脑干上行网状激动系统,丘脑弥散性投射系统和大脑皮质是维持正常意识的解剖基础。当脑干、间脑网状结构或大脑皮质广泛性损害 时皆可引起昏迷;由于感染中毒等脑外器官或全身性疾病时,影响到脑细胞代谢或神经递质及受体时也可引起昏迷。 应当指出,无论是网状结构病变或大脑半球损害,病变发展之速度较损害之大小对意识 Coma is the most serious disturbance of consciousness, that is, complete loss of consciousness, the patient’s internal and external environment of all stimuli are not responsive. Upward reticular activation of the brainstem, diffuse projection of the thalamus and the cerebral cortex are the anatomical basis for maintaining normal consciousness. When the brainstem, mesencephalic structures or extensive damage to the cerebral cortex can cause coma; due to infection and other brain organ or systemic disease, affecting brain cell metabolism or neurotransmitter and receptor can also cause coma. It should be noted that both the lesion of the reticular structure or the damage to the cerebral hemispheres, the lesion development rate of damage than the size of awareness