Medical issue that would render someone unconscious, is fully recoverable if aid comes in time, but lethal if delayed much longer

Question

This should be a pretty easy one for you all. I need to render someone unconscious, and unable to be woken, in a story. I need it to be due to an unexpected medical issue, I don't care rather that is due to some undiagnosed personal aliment or an outside source like being hit on the head by a coconut. It should happen inside their home.

I want them to make a full recover after making it to the hospital, with a 911 call being delayed by 15 minutes and then the ambulance needing to make it to a rural area to recover the injured individual. However, I would like the condition to have a potentially fatal, or at least result in a severe long term disability, if the response had been delayed by another 10-20 minutes.

What are some of the more probable medical causes of such an issue?

Answer 1

Hypoglycemic shock

If a person suffers from low blood sugar (well below 70 mg/dL), they will begin to experience symptoms of anxiety such as trembling, sweating, nausea, etc...

As the blood sugar continues to drop, they will begin to show neurological symptoms such as slurred speech and fatigue, confusion and drowsiness.

If blood sugar levels remain consistently low, the sufferer will eventually lose consciousness through seizure and coma.

At this point, the brain is trying to conserve energy for basic cellular processes, and brain cells switch over to ketogenesis, desperately attempting to use a back up metabolic pathway to keep the cells alive, and thus has no time to worry about trivial things like staying awake.

After a few hours of this, if the cells are unable to get sufficient ketones from the liver, they will die.

However, a quick injection of glucose before then will cause immediate and rapid reversal of all symptoms, causing the victim to awaken with little more than a possible headache and feeling of extreme hunger.

Generally, hypoglycemic shock is very rare. The body works extremely hard to keep blood glucose levels around 100 mg/dL, however, a number of mostly simple things can lead to a severe drop.

If a person is a type-1 diabetic who takes too much insulin, the result is quite often low blood sugar. This is why type-1 diabetics often carry candies or other sources of a quick glucose burst.

Another possible source of hypoglycemic shock is post-prandial hypoglycemia. In this case, the body's insulin response to food is either highly delayed or improperly decoupled from feedback mechanisms. The result is an overproduction of insulin, and a delay or inability to produce cortisol to counteract the effects. Insulin signals the liver and other tissues to convert blood glucose to fat, and thus causes a drop in blood sugar. Normally, the insulin production stops as the glucose level drops, but there are situations where this either doesn't happen, or the initial increase of insulin is too rapid, causing hypoglycemia.

The above situation can also be caused by an insulinoma, which is a type of tumor in the pancreas. Although the tumor is usually benign, it is an "active" tumor, which means it produces hormones, in this case, insulin. Because there is such a large excess of insulin producing cells due to the tumor, the resulting insulin response is also magnified dramatically. Since they are tumor cells, they may also be defective and fail to respond to feedback mechanisms that would normally cause them to cease insulin production at inappropriate times.

Answer 2

Recycled answer from this closed question.

How do I make my young character getting shot and recovering realistic with the following narrative needs?

Epidural hematoma.

https://en.wikipedia.org/wiki/Epidural_hematoma

Epidural hematoma is when bleeding occurs between the tough outer membrane covering the brain (dura mater) and the skull. Often there is loss of consciousness following a head injury, a brief regaining of consciousness, and then loss of consciousness again. Other symptoms may include headache, confusion, vomiting, and an inability to move parts of the body. Complications may include seizures.

Treatment is generally by urgent surgery in the form of a craniotomy or burr hole. Without treatment, death typically results. The condition occurs in one to four percent of head injuries.

This is the one where people get knocked out; get back up and seem good, then drift out of consciousness and die a few hours later. This is why everyone with head trauma gets a CT scan in the ED. Death occurs because the accumulating blood presses the brain. You can prevent it by letting the blood go somewhere else with an emergency surgery.

Intracranial Hemorrhage Associated with Tangential Gunshot Wounds to the Head

Your character is hit on the head hard but gets back up and seems fine. About a half hour later your character passes out. The bleeding has accumulated enough to press on the brain. If that goes on she will die. If she can get surgery she will live.

Answer 3

Combine something like a slip and fall and bleeding or fall from height. A fall that involves head injury can likely render person unconscious. External bleeding from hitting an object during fall is plausible. Internal bleeding is more plausible the higher the fall.eg. fall from a roof, tree or down a set of stairs. Either way, if a person is unconscious and bleeding beyond some rate, it is a potentially lethal situation.

Depending on bleed rate expected time to live can be anywhere from 5 minutes to bleeding will stop on its own without external intervention.

Answer 4

Seizure or narcolepsy.

Option A: seizure

A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness.

More severe seizures could cause a total loss of consciousness. It would not be possible to wake someone from a seizure. Moreover, seizures could be caused by a medical condition (epilepsy) or due to outside factors. Even dizzying lights or sounds could trigger a seizure in an otherwise healthy individual.

Anything that interrupts the normal connections between nerve cells in the brain can cause a seizure. This includes a high fever, high or low blood sugar, alcohol or drug withdrawal, or a brain concussion.

You ask that the character be able to make a full recovery. Most people do recover fully from a seizure. However, you also stipulate that the condition have the potential to be fatal or result in a severe long-term disability. A seizure could be fatal if the person stops breathing or chokes. If your character vomited, for instance, they could choke on their own vomit, or the airway could be obstructed by their tongue.

A seizure may cause a person to have pauses in breathing (apnea). If these pauses last too long, they can reduce the oxygen in the blood to a life-threatening level. In addition, during a convulsive seizure a person's airway sometimes may get covered or obstructed, leading to suffocation.

Option B: narcolepsy

Narcolepsy is a medical condition that causes sudden sleep.

Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances.

You say you want to render someone unconscious. While narcolepsy does induce a heavy sleep, from which it is extremely difficult to wake someone, it does not cause loss of consciousness. However, for your purposes, that might be fine. Narcolepsy may result in sudden loss of muscle tone and hallucinations.

The most severe attacks result in a total body collapse during which individuals are unable to move, speak, or keep their eyes open. But even during the most severe episodes, people remain fully conscious, a characteristic that distinguishes cataplexy from fainting or seizure disorders.

People with narcolepsy make a full recovery. However, a sleep attack could be fatal or dangerous, depending where it happens. A person may hit their head hard on the concrete. They may get a sleep attack while driving a car or crossing the street. They may fall down stairs. They may experience sleep while bathing or swimming, and thus be at risk of drowning. All these could be potentially fatal scenarios.

Narcolepsy is a medical condition that occurs sporadically, meaning it happens in individuals with no family history of the condition. It can start later in life and may be brought on by hormonal changes, psychological stress, change in sleep patterns, an infection, or a vaccine. It is common enough that a sudden onset would be normal.

Narcolepsy affects both males and females equally. Symptoms often start in childhood, adolescence, or young adulthood (ages 7 to 25), but can occur at any time in life.