Answers to Your Brain Injury Questions
With advancements in science and technology, medical experts have been able to answer many questions about brain injury, yet some remain a mystery. In the past, people who suffered brain injuries did not receive a good prognosis: it was not expected that they would live long. Today, many survivors of serious brain injury can be treated, thus maximizing their chances of living on to their highest potential.
The following are some commonly asked questions about brain injury and the answers provided by prominent members of the medical field.
What is brain damage? Are there different types?
There are several different types of brain injury. In some cases, neurons (brain cells) can be damaged directly and killed. Axons (part of a neuron) can be torn or sheared. This is often seen in closed head injuries. Swelling of the brain and surrounding structures can indirectly kill neurons due to the added pressure on the brain. Loss of oxygen can also result in brain damage. An example of this brain injury is cerebral palsy.
For survival, are some parts of the brain more important than others are?
Yes. The brain stem for example, is responsible for involuntary regulating functions, such as breathing and heart rate. These functions are essential for survival, so when brain injury affects the brain stem, the consequences can be deadly. The cortex, on the other hand, is less necessary for survival, BUT it is very crucial to making us who we are. Therefore, if the brain stem in functioning and the cortex is severely damaged, you may have a living person, but not much else.
How resilient is the brain? How much trauma can it handle?
The answer to these questions depends on a number of factors. For a young person to suffer a first-time brain injury there is a remarkable ability to improve IF there is NO significant tissue destruction, brain stem damage, or loss of oxygen to the brain.
Many factors can reduce the recovery potential after a brain injury. The following are all bad signs:
- bleeding in the brain stem
- massive intracranial bleeding, or other large mass effects
- surgery is needed to remove parts of brain
- loss of oxygen due to substantial loss of blood
In addition, for a person who has suffered a previous brain injury, even a bump on the head can have significant effects. It is thought, in these cases, that the brain has already used up its “reserve.”
Can a person with a brain injury recover lost ability or function?
It depends on the individual’s condition. Most patients with mild traumatic brain injury fully recover. However, it is possible for these patients to suffer persistent cognitive disabilities, even with rehabilitation. Generally speaking, the more severe the initial injury, the more difficult it will be for the patient to recover with treatment. It is important to note that patients with severe brain injury have been able to ultimately return to normal life despite extensive brain injuries.
The brain cannot be ‘fixed’ per se. In time, brain areas damaged by trauma can improve, and these areas may be able to make up from permanently obliterated parts of the brain. Rehabilitation can improve overall coordination of the body-brain function…but permanently destroyed brain regions are just that….permanently destroyed.
Can brain cells grow back?
Dead brain cells are unable to grow back. There is also no evidence to show that surviving brain cells can replicate. However, there is ample evidence of “sprouting” a phenomenon in which surviving neurons send out axonal “sprouts” or extensions into damaged brain areas to communicate with neurons that have lost their input.
How can you gauge the outcome of a brain injury in the first few days and weeks?
Typically, though not always, the speed at which a person regains consciousness and their initial rate of recovery will help set the course for their recovery. To get a good idea of the possible outcome can take days or even weeks. Infections, serious swelling, and intracranial pressure (all considered “secondary” brain injuries) can cause additional damage.
What about shrapnel and other brain penetrating injuries?
Penetrating brain injury, such as shrapnel, can complicate traumatic brain injury by causing high pressure that can choke off blood supply, causing bleeding inside the skull, or by damaging important areas of the brain, which control specific functions. Blast injuries can also affect the chest, causing lung tissue damage, which can impair breathing or cause an air emboli to enter the bloodstream. Both of these ancillary injuries can worsen the severity of a serious brain injury.
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