Ruling Out Other Conditions
Before testing for brain stem death can begin, doctors must carry out a series of checks to ensure that the symptoms aren’t being caused by other factors, such as:
- an overdose of illegal drugs, tranquillisers, poisons or other chemical agents
- an abnormally low body temperature
- severe under-activity of the thyroid gland
Once these factors have been ruled out, tests are carried out to confirm brain death. The diagnosis of brain death has to be made by two senior doctors. Neither of them can be involved with the hospital’s transplant team.
The doctors will explain the tests to you and they’ll keep you informed about your loved one’s condition at all times.
Boosting Your Brain Damage Recovery Chances: Key Points
It is vital to remember that statistics and figures about brain damage recovery chances are not definitive. Even when the odds look grim, its always possible to achieve a good recovery.
There are dozens of severe brain injury recovery stories where patients defy all expectations and surprise their doctors with their progress. And in each case, it was because the person ignored negative predictions and persevered with therapy.
We hope this article helped you better understand the various factors involved in determining ones chances of recovering from brain damage and how to increase your odds. Good luck!
Factors That Influence Recovery Chances
While the severity of brain damage plays a major role in predicting recovery outlook after TBI, it is not the only factor involved.
Other factors doctors may look at to predict brain damage recovery chances include:
- Duration of coma. The less time a patient is in a coma after brain injury, the better their chances of a good recovery.
- Post-traumatic amnesia. When the person emerges from a coma, they go through a period of amnesia and confusion. Sometimes this period only lasts a few hours, but typically it lasts days or even weeks. The shorter the amnesia lasts, the better the prognosis.
- Age. In general, TBI patients over the age of 60 or under the age of two have the most limited chances of recovery.
- Pupil reactivity. More reactive pupils are associated with greater functional recovery.
- Location of injury. Chances of recovery are generally higher for those with focal head injuries than diffuse head injuries because damage is limited to one area of the brain as opposed to multiple areas.
- Pre-existing health conditions. Individuals with a prior history of health conditions like anxiety, depression, headaches, and seizures generally require more time to recover from brain injury.
- Secondary effects. Secondary effects of brain damage such as personality changes, sleep problems, and chronic pain may interfere with ones motivation to pursue recovery.
- Motivation. Recovery outcomes are best when the individual is highly motivated to pursue recovery.
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How Is Brain Death Related To Organ Donation
In order to be medically able to become an organ donor, an individual must pass away on a ventilator in a hospital. While being brain dead is not the only way this can happen, it is the most frequent condition of those who become organ donors.
Only after someone has been declared brain dead, legally dead, the hospital will contact the local organ procurement organization to begin the consideration of donation. Not until this point is it looked up to see if someone is registered as a donor and/or the family is approached to be asked if they would like their loved one to be a donor.
Once a legal record of donor registration is found and/or a family has consent then the organ donation process will begin. If someone is not a registered donor and the family does not consent the person will not become a donor.
What Is Brain Death
Brain Death is when an irreversible and complete loss of brain and brain stem function has taken place. This means that there is absolutely no brain activity and brain activity will not return.
It is considered both a legal and medical definition of death.
At this point, the patient is incapable of surviving without mechanical support.
You can see the difference of a brain with blood flow and brain activity, and one that is without any function.
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What Happens To An Individual While These Tests Are Being Done
The individual is placed on a machine that breathes for him or her, called a ventilator. This machine is needed because the brain can no longer send signals telling the body to breathe. Special medications to help maintain blood pressure and other body functions may also be given. During the brain death testing, the ventilator and medications continue but they do not affect the results of the testing.
How To Interact With A Loved One Who Is Unconscious Or At A Low Level Of Responsiveness
The most natural way of interacting is to talk to your loved one, even though he or she may not respond or understand. Telling him or her about recent events in your life, whats going on in your family or neighborhood, or the latest news may make you feel connected. Talking with your loved one about what you are doing as you provide care can increase your comfort with caregiving. For example, telling your loved one that you are going to move his or her arms and legs to help prevent joint tightness might make you feel more comfortable with this task. Only do these range of motion exercises if you have been instructed to do so by a doctor, nurse, or therapist.
Touch is another way to feel connected. Some family members have said that giving a massage or putting lotion on the hands or face of their loved one helps them to feel close to them. Its also important to give your loved one time for quiet and rest, such as by turning the TV off. You should also avoid overstimulation as this may cause rapid breathing, muscle tightening, teeth grinding, restlessness, and fatigue.
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S To Increase Brain Damage Recovery Chances
Utilizing a combination of various rehabilitation methods can promote better chances of brain damage recovery. Because traumatic brain injuries can affect a wide variety of cognitive and motor functions, a personalized approach to recovery that identifies and targets each individuals weaknesses is ideal.
Commonly used practices to improve recovery outcomes after brain injury include:
Rehabilitative therapies will provide you with helpful guidance to promote recovery, but its ultimately up to you to continuously practice those exercises and activities to optimize your outcomes. The more you practice, the more your brain will adapt, and the better youll get.
How Is It Decided That An Individual Is Brain Dead
A doctor will do tests to make a diagnosis of brain death. These tests are based on sound and legally accepted medical guidelines. Tests include a clinical examination to show that an individual has no brain reflexes and cannot breathe on his or her own. In some situations, other tests may be needed. You can ask your doctor to explain or show you how brain death was determined for your loved one.
Possibly, an individual may show spinal activity or reflexes such as twitching or muscle contractions. Spinal reflexes are caused by electrical impulses that remain in the spinal column. These reflexes may happen even though the brain is dead.
Brain Death Is Different From Vegetative State
The difference between brain death and a vegetative state, which can happen after extensive brain damage, is that it’s possible to recover from a vegetative state, but brain death is permanent.
Someone in a vegetative state still has a functioning brain stem, which means:
- some form of consciousness may exist
- breathing unaided is usually possible
- there’s a slim chance of recovery because the brain stem’s core functions may be unaffected
Someone in a vegetative state can show signs of being awake. For example, they may open their eyes but not respond to their surroundings.
In rare cases, a person in a vegetative state may show some sense of response that can be detected using a brain scan, but not be able to interact with their surroundings.
Other Brain Death Testing
After completing the physical assessment, the physician may elect to order additional testing. While it is typical for both a physical assessment and an apnea test to be done, some people who are not brain dead cannot tolerate apnea testing. Often, in those cases, a flow study will be done. These studies are done to see if blood is traveling to the brain through the bloodstream. If the study shows that no blood is reaching the brain, the test is consistent with brain death.
Some physicians will use an EEG, or electroencephalogram, which is a test that measures brain waves. A person who is brain dead will have a “flat” EEG, as brain waves will be absent.
Atropine, a prescription medication that causes the heart rate to increase, an also be administered as an ancillary test for brain death because it is not effective in brain dead individuals. If the heart rate increases notably after the medication is given, this suggests that a person is not brain dead.
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Taking Care Of Yourself And Other Family Members
Family members of a person in the VS or the MCS often feel a sense of loss or grief for the relationship they had before the injury. You can cope with these feelings in a few ways. A person in the VS or the MCS may make slow progress or go for long periods with no progress. Keeping a journal of the changes you have seen may be comforting. This may let you see how your loved one is more able to respond than he or she was at an earlier point in time.
Having a loved one who is in the VS or the MCS can be physically and emotionally draining. Dealing with this alone can be too much for one person. Its important to rely on support from others. You can look to existing supports, such as family, friends, and religious groups. You can also find new supports.
Other resources to consider include support groups and agencies, and the internet. You can contact the Brain Injury Association of Americas National Brain Injury Information Center . The BIAA can give you contact information for the closest chapter of your state brain injury association. Health care providers such as doctors, therapists, and social workers may also be good sources of information about supports available to you
An Internal Medicine Doctor Explains What Life
A person is declared brain dead, but the family insists on keeping that person on a ventilator.
They believe that as long as the heart beats , that their family member is alive and cant possibly be dead.
What else besides heartbeat can a brain dead body do while being prevented from decomposing via the ventilator ?
First off, the hair and nails will continue to grow, get longer.
At this point , all we are doing is keeping the individual cells and organs of the body alive, says Jacob Teitelbaum, MD, medical director of the Fibromyalgia and Fatigue Centers nationally, and author of The Fatigue and Fibromyalgia Solution.
So hair will grow, nails will grow, and urination will continue.
Interestingly, in the Jahi McMath case, the day-by-day reports have never mentioned anything about a catheter to collect urine, even though Jahis kidneys were allegedly functioning, leading to excrement.
And if the kidneys are working, the liver, pancreas and entire G.I. tract must also be working. Seems that the body, then, was alive, right?
Dr. Teitelbaum says, Meanwhile, the muscles will atrophy and shrink, the body will get severe contractures and bed sores, and the process that occurs after burial occurs instead, in a hospital bed, albeit more slowly.
So even though some of the bodys systems are functioning, the PERSON is dead. The person as a whole, is dead.
The body can continue to do most of the basic metabolic functioning on life support, says Dr. Teitelbaum.
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Can You Heal A Damaged Brain
No, you cannot heal a damaged brain. Medical treatments can just help to stop further damage and limit the functional loss from the damage. The healing process of the brain is not the same as the skin. When the skin gets damaged, such as due to minor skin wounds, it usually heals wells without leaving scars. Major wounds can heal with scarring. Skin healing is completed by replacing the damaged/lost cells with new ones. In the brain, the damaged cells are nerve cells known as neurons and neurons cannot regenerate. The damaged area gets necrosed and it is never the same as it was before.
When the brain gets injured, you are often left with disabilities that persist for the rest of your life. Rehabilitation can help in functional recovery, but structural abnormality is hard to correct with available treatments.
How Is A Damaged Brain Treated
A traumatic brain injury needs emergency care that aims at
- Making sure there is enough oxygen: Oxygen will be delivered through a face mask connected to an oxygen cylinder. You may be put on artificial respiration with the help of ventilators.
- An adequate blood supply: A blood transfusion may be done.
- Maintaining blood pressure with fluids and medications.
- Preventing any further injury to the head or neck.
Doctors will focus on minimizing further loss due to inflammation, bleeding or reduced oxygen supply to the brain.
Hyperbaric oxygen therapy
The doctor may prescribe hyperbaric oxygen therapy to improve the lost cognitive functions/skills, such as reading or cooking, after the brain damage. Currently, HBOT is one of the most important therapies for TBI. It involves putting you in an oxygen-rich chamber that increases the blood oxygen levels ten times the normal level.
Noninvasive brain stimulation
Noninvasive brain stimulation without the introduction of any instruments through the skin. It is a painless procedure for the treatment of TBI. Studies have shown that it could improve depression and cognitive function after TBI.
There is something known as a stem cell that seems to be a promising option to regenerate damaged neurons in the brain. Stem cells are a special type of cells that can be trained to develop into any kind of cell, such as a neuron. However, research is ongoing to determine the efficacy and safety of the therapy.
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A Summary Of Tk’s Clinical History
TK’s autopsy report includes a narrative of his clinical history with medical details that will be relevant for the philosophical analysis of brain death that follows below. In brief, TK was born in 1979. When he was four years old, he contracted Haemophilus influenzae meningitis that put him into a coma. While staying in a Nebraska hospital for treatment, he experienced an increase in intracranial pressure so severe that it separated the bony plates of his skull. An EEG revealed no electrocerebral activity, but his family was opposed to his removal from life support.
For several weeks following his initial infection, TK experienced severe temperature and blood pressure fluctuations that required days of dopamine infusion to support his blood pressure. Urine output fluctuated tremendously suggesting that he had diabetes insipidus. There were also dramatic shifts in his serum sodium. After this period of crisis, however, TK’s temperature, blood pressure, urine output, and serum sodium levels became stable.
Transitions To Different Levels Of Care
During recovery, people in the VS or the MCS may get care in many settings. A person with a DOC will likely start treatment in an acute care hospital the focus is on saving the patients life and stabilizing the patient. Once those needs are met, the focus moves to restoring as much function as possible. Sometimes this takes place in an acute rehabilitation hospital. These hospitals provide high-intensity, team-oriented services. Services include physical therapy, occupational therapy, speech-language therapy, recreational therapy, neuropsychological services, and medical and nursing care.
Some patients dont go from the acute care hospital to an acute rehab program. These patients may go directly to a long-term acute care hospital , a skilled nursing facility , a subacute rehab program, or a nursing home. They may also go home with family or have home health care or outpatient treatment. People who get care in an acute rehab program first are usually discharged to one of these places as well.
When patients are medically unstable or dont show signs of recovery for a long time, doctors may consider palliative care. In this type of care, the focus of treatment shifts from recovery to comfort.
Many factors affect where a person with severe DOC or other severe impairments goes after leaving an acute care hospital or rehab program. These factors include:
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Rewiring The Brain To Restore Abilities After Stroke
When you activate neuroplasticity through exercise, you helpyour brain repair lost connections. That not only lets you relearn certainactivities, it also prevents neuronal decay and keeps your condition fromdeteriorating.
Therefore, even if you have suffered a severe stroke, you can still make a functional recovery. Stay disciplined, work hard, and you will see results.
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