Anoxic Brain Injury – BrainAndSpinalCord.org | Brain …

Adequate oxygen is vital for the brain. Many factors can cause the brain to receive inadequate oxygen. When oxygen levels are significantly low for four minutes or longer, brain cells begin to die and after five minutes permanent anoxic brain injury can occur. Anoxic brain injury which is also called cerebral hypoxia or hypoxic-anoxic injury (HAI) is a serious, life-threatening injury; it can cause cognitive problems and disabilities. Some HAI injuries are due to a partial lack of oxygen; the term hypoxic means partial lack. Other HAI injuries are due to a complete lack of oxygen; the term anoxic means total lack. The greater the loss of oxygen, the more wide-spread and serious the injury will be.

The death of brain cells interrupts the brains electrochemical impulses and interferes with the performance of neurotransmittersthe chemical messengers which transmit messages within the brain. The neurotransmitters regulate body functions and influence behavior. For example, the neurotransmitters serotonin, dopamine, and norepinephrine help regulate moods, while the endorphins increase pleasure and control pain. The neurotransmitter acetylcholine plays an important role in memory.

See: Brain Injury Statistics

There are four types of anoxia, but each can cause the same serious damage to the brain.

Usually HAI will begin with a loss of consciousness or a coma, although this is not always the case. A coma resembles sleep, but the person will not wake up when called or stimulated in some way. After the initial unconscious period the person may lapse into a persistent vegetative statethe person is not comatose, but yet he or she will not respond to being stimulated; the persistent vegetative states is often called wakeful unresponsiveness.

If the person regains full consciousness, he or she may experience a wide-range of symptoms which resemble the symptoms seen after head trauma. The extent and type of symptoms depend on the amount of brain tissue damage and part of the brain where the injury occurred.

Loss of consciousness is a serious medical emergency; call an ambulance if you are with someone who has lost consciousness. If you or someone you know are experiencing symptoms of anoxic brain injury, do not delay seeking medical help. Problems such as heart arrhythmias can cause significant lack of oxygen to the brain without inducing a lack of consciousness; the person may simply be extremely sleepy or fatigued.

Diagnostic tests for anoxic brain damage include:

Recovering from anoxic brain damage is difficult. Many factors contribute to the degree and rate of recovery. The amount and kind of brain damage is a critical factor; anoxic brain injury can be mild, moderate, or severe. The length of time spent unconscious or in a coma, coupled with how much normal function is recovered within the first month of the injury can indicate the chance of long-term recovery. People who have experienced severe anoxic brain injury may remain in a coma or vegetative state.

Their chances of recovery may be minimal. Cases of moderate anoxic brain injury have a better outcome, but recovery may still take months or years. People with mild anoxic brain injury usually make a full or nearly full recovery, and are able to live lives that are relatively normal and symptom free.

When treating anoxic brain injury, doctors first attempt to pinpoint the cause of the injury and treat it. For example, if lack of oxygen is due to a stroke, the first priority will be to treat the patient for stroke. If the problem is due to heart arrhythmia, steps will be taken to regulate and stabilize the hearts rhythm. Efforts to stop further brain damage will be combined with treatments for the cause of the problem. Every effort will be made to restore normal oxygen availability to the brain. The patient will be kept cool in order to reduce further brain damage, because the brain can reach high temperature during oxygen deprivation.

Steroids may be given in an attempt to reduce brain swelling, since swelling can also damage the brain. Barbiturates may be given to reduce brain activity and allow the tissue time to recover. Sometimes people with anoxic brain injury have seizures. Anti-seizure medications will be used to control this problem. Severe seizures may be treated with anesthesia. In many instances, the patient must be put on a ventilator during the first phase of treatment. This is frightening for the family, but it can be a step taken to assure the proper level of oxygen will be maintained so that the patient has a chance of recovery. Of course, all involved must be prepared for the possibility of brain death (no brain activity, which means no chance of recovery).

The longer a person remains unconscious, the greater the chance of brain death. The medical team should keep the appropriate family members aware of exactly what is going on; do not hesitate to ask questions about every treatment. There are no dumb questions. Once the patient is stable and life-threatening injuries have been treated, the rehabilitation phase of treatment will follow. Generally, chances of recovery are better when rehabilitation can be started quickly, particularly with people over 25. As people age the muscles atrophy more quickly with bed rest, so it is important to begin movement as soon as possible.

During rehabilitation the patient and his or her family will work with a multidisciplinary staff including doctors, nurses, physical and occupational therapists, and other specialists to devise an individualized program designed to return the patient to the maximum level of function. The rehabilitation phase may include:

Counseling the patients family and caregivers can help with rehabilitation by talking with all members of the rehabilitation team and making sure that they understand what the goals of therapy are. Love and emotional support is vital for the patient during this time. Taking care of someone with anoxic brain injury can be a physically and emotionally draining experience; the persons physical needs may be taxing and they may not relate to you in the way they once did.

If you are taking care of a loved one with anoxic brain damage, make sure that you also take care of your own physical and emotional needs. A support network is important. Do not hesitate to tell family and friends what you need and do not hesitate to take advantage of support systems offered by the hospital or rehab center.

The best way to avoid the long-term effects of an anoxic Brain Injury is to avoid injury altogether. While accidents can happen, there are steps you can take to reduce the risk of anoxic brain damage to yourself and your loved ones:

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