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In an unfortunate turn of events, the world is now in mourning as renowned Prince Al‑Waleed bin Khalid bin Talal Al Saud, affectionately known as Saudi Arabia’s ‘Sleeping Prince’, passed away at age 36 in Riyadh after remaining in a coma for two decades. The 15‑year‑old cadet fell into a coma following a devastating car accident in 2005 while studying at a military college in London. Despite continuous life support and international medical care, he never regained consciousness.
Now, to better understand what causes a coma and how long it can last, we talked to Prof (Dr) Chhitij Srivastava, Director & HOD, Neurosurgery, Apollo Hospitals Lucknow, to educate our readers on the devastating stages of coma and how fast recovery can be.
A 20-Year Vigil of Hope![Prince Al‑Waleed bin Khalid bin Talal Al Saud SLEEPING PRINCE]()
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In 2005, Prince Al Waleed bin Talal Al Saud, the eldest son of Prince Khaled bin Talal Al Saud, who is a prominent Saudi royal and nephew of billionaire Prince Al Waleed bin Talal, got into an unfortunate accident in London and received immediate care there. Later, the unconscious prince was transferred to Riyadh to King Abdulaziz Medical City, where his father, Prince Khaled, vowed that he would never have him taken off life support.
The mourning father took to X (formerly Twitter) to express his grief and wrote in Arabic, “With hearts believing in Allah will and decree, and with deep sorrow and sadness, we mourn our beloved son: Prince Al-Waleed bin Khaled bin Talal bin Abdulaziz Al Saud, may Allah have mercy on him, who passed away today.”
{يَا أَيَّتُهَا النَّفْسُ الْمُطْمَئِنَّةُ، ارْجِعِي إِلَىٰ رَبِّكِ رَاضِيَةً مَّرْضِيَّةً، فَادْخُلِي فِي عِبَادِي، وَادْخُلِي جَنَّتِي}
بقلوب مؤمنة بقضاء الله وقدره وببالغ الحزن والأسى ننعى إبننا الغالي
الأمير الوليد بن خالد بن طلال بن عبدالعزيز آل سعود رحمه الله
الذي انتقل… pic.twitter.com/QQBbMWGOOG
Over the years, various tiny movements, such as twitching fingers, gave his family as well as the internet an hope for Prince’s recovery. However, now his story will echo through the Middle East as an example of the strength of faith and family stability.
Funeral prayers were observed at Imam Turki bin Abdullah Mosque, followed by condolences during the few days at the royal palace.
What is the Duration of a Coma?
Medically, comas tend to be acute and can last days to a few weeks. During that time, most patients wake up or even switch to other states of consciousness. According to Dr Srivastava, "Comas are something that can stretch between months and in some cases years, in exceptional cases even decades, which only happens when the injury is severe."
"Sometimes an acute coma may be followed by a persistent vegetative state (PVS) (also known as a coma vigil) in which the patient remains awake, but aware of nothing. The chances of coming back to life reduce with time; after four months, the probability of partial recovery reduces to below 15% and full recovery becomes almost impossible," explained Dr Srivastava.
ALSO READ: Traumatic Brain Injury may prompt Long-term Neurodegeneration
What Dictates Coma Duration?
Dr Srivastava explained that coma duration and outcome depend on several key factors. These include:
1. Cause and Severity of Injury
Traumatic brain injury (TBI), like in Prince Al‑Waleed’s London accident, can cause irreversible damage, limiting chances of recovery.
2. Advances in Life‑Support Care
Modern intensive care allows patients to be sustained for years via mechanical ventilation and feeding tubes, but prolonged support increases the risk of complications like infections.
3. Neuroplasticity and Stimulation
Some recoveries, such as via vagus‑nerve stimulator or sensory stimulation, point to brain plasticity, yet such interventions are still experimental.
4. Time Factor
Time is a strong predictor; if a patient wakes up in the initial week or month, then a good chance of recovery is there, but the odds of meaningful recovery drop sharply after several months.
ALSO READ: What Is Diabetic Coma? Understanding Symptoms, Risk Factors And Prevention
How Long Does a Coma Last-and What Is Next?
Comas do not tend to last only one moment. The recovery phases are the following:
- Vegetative State (VS): Awake but not conscious-the eyes are open, but no intended response.
- Minimally Conscious State (MCS): Occasional and inconsistent responses.
- Confusional State: Unoriented and alert.
- Complete Awareness: Increase in memory, mind-related and physical activity progressively.
“The change of coma state to death is usually caused by secondary complications such as pneumonia or organ failure,” explained Dr Srivastava.
Dr Srivastava's Thoughts on Sleeping Prince’s Condition
The 20-year coma of Prince Al-Waleed is one of the longest recorded in traumatic brain injury cases. His unending life support shows how modern medicine, endless human hope and strong cultural belief can interact.
Dr Srivastava explained, “Cases such as the Saudi sleeping prince are uncommonly rare. In medical terms, the probability of a decent recovery after a year is very small. However, life-support measures can support the biological preservation far longer."
ALSO READ: Symptoms of Diabetic Coma
A Painful Goodbye
Comas’ usually lasts a few days or weeks, although such an extreme case as the ‘Sleeping Prince’, may last decades and is an exception. But however long the process, the demose of afamily member is never easy and calls for mourning wgile remembering the Prince’s survival of the human spirit, familial loyalty, and the perennial ethical dilemmas of providing life-saving care in a state of permanent unconsciousness.