Determination of the Moment of Death

Death Due to Coma: Causes and Pathophysiology

Death due to coma is a critical subject in forensic medicine and toxicology. It involves complex physiological mechanisms leading to irreversible cessation of brain function.

Causes of Coma Leading to Death

• Traumatic brain injury
• Stroke and cerebral hemorrhage
• Hypoxic-ischemic encephalopathy
• Metabolic disorders (e.g., diabetic ketoacidosis, hepatic encephalopathy)
• Drug toxicity and poisoning

Pathophysiology of Coma and Death

Coma results from severe dysfunction in the brainstem and cerebral cortex. The progression to death occurs when brainstem reflexes are lost, leading to respiratory failure and cardiovascular collapse.

Forensic Determination of Death

Medical examiners assess brain death criteria, including:

• Absence of brainstem reflexes
• Unresponsiveness to external stimuli
• Apnea test confirmation

Advanced imaging techniques such as EEG and cerebral blood flow studies aid in confirming irreversible brain damage.