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The brain needs a constant supply of oxygen and in fact uses 20% of our total oxygen intake. Any interruption in our oxygen supply leads to hypoxia which disturbs brain functioning. Consciousness is lost within 15 seconds and brain damage begins to occur after about 4 minutes without oxygen.
There are many potential causes of cerebral hypoxia including:
• Cardiac or respiratory arrest
• Very low blood pressure
• Complication of general anaesthesia
• Smoke inhalation
• Carbon monoxide inhalation
• Electric shock.
Patients who suffer serious hypoxia are usually taken to intensive care and put on a ventilator. They may also need medication to maintain an adequate blood pressure and normal heart beat.
Many factors can help predict the outcome after hypoxia:
Age: People over the age of 50 tend to do less well.
Duration of the hypoxic episode: The extent of damage to the brain, which relates to the time the brain was deprived of oxygen.
Duration of coma: The duration of unconsciousness reflects the severity of the brain injury, but not the duration of a medically induced coma.
Pupil reaction: If pupils do not react to bright light this is an unfavourable sign.
Electroencephalogram: An EEG which displays normal electrical activity of the brain in the early stages shows a very good chance of making a full recovery. Brain imaging: CT and MRI scans can show brain swelling and the areas affected however, they may show very little for some patients.
Somatosensory evoked potentials: SSEPs are electrical responses in the brain to sensory stimulation. The absence of SSEPs is associated with a poor outcome.
The body responds to hypoxia by increasing blood flow to the brain to try and restore an adequate oxygen supply however, it can only increase brain blood flow to about twice the normal level. If this is not enough to compensate for the hypoxia, as brain cells are particularly sensitive to a lack of oxygen, brain function will be disturbed. Some areas are more vulnerable than others, in particular the parietal lobes and occipital lobes, hippocampus, basal ganglia and cerebellum.
Long-term consequences depend on the severity of the hypoxia and the extent of brain damage. In mild or short-lived hypoxia, there may be a full or near normal recovery. However, if the injury was more severe there are likely to be long-term effects. These vary from person to person however, the vulnerability of particular parts of the brain to hypoxia gives some distinctive features to this type of injury.
Damage to the:
• cerebral cortex, cerebellum and basal ganglia may lead to limb weakness and disturbances of movement, balance and co-ordination.
• occipital lobe may cause a loss of visual function.
• hippocampus causing memory problems which may be quite severe.
• areas of the brain involved in the production of speech, finding the right words and understanding language. Written communication may also be affected.
• frontal lobes may lead to disturbances in being able to think and reason, to process complex information and make considered judgements.
• frontal lobe may produce changes in personality, including irritability, poor tolerance of frustration and impulsiveness. There may be apathy and lack of insight, as well as agitation and mood swings.
At Head Injury UK our specialist brain injury solicitors understand hypoxic brain injury and the importance of early rehabilitation. Whilst the outlook for hypoxic brain injury is uncertain we always prioritise rehabilitation in our work with clients and their families. If you or a loved one has been affected by head injury caused by someone else, please contact Ian Shovlin or call on 0800 073 0988.
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