Hypoxic Brain Injury

I am inquiring if anyone, who has, or either sufferers from and/or recovered from this type of brain injury can help me understand this diagnosis and if a true recovery is possible.

Also is any one able to help me obtain some medical information in regards to the asthma element of brain injury and the recovery process.or even how i can get medical literature about this subject. Any information would at this time be truly appreciative

kind regards jellyb

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Hypoxia or hypoxic means lack of oxygen, the brain like any organ needs oxygen to survive and without will begin to die.

A brain injury from this can be mild through to severe depending on the amount of time there was insufficiant oxygen. It can be caused by a number of things from strangulation to asthma anything which can inhibite oxygen transfer?

The prognosis depends on the severity on brain damaged and the time scale involved.

If you google on your computer, hypoxic brain injuries it willl come up with a lot of interesting and more indepth answers.

Hope this ok

pm if need me.

love Andrea xxx

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Hi Jaycie,

I assume you are asking this concerning Holly-Anna - I am so so sorry to hear that she is still so unwell, this must be a nightmare time for you and your family.

As Andrea has said, hypoxic brain injury is basically caused by some of the brain cells dying as a result of an insufficient supply of oxygen. The effects of this are very much dependent on where the affected cells are in the brain and how many of them are involved. The symptoms can range from being so mild as to be almost unnoticable, to being severe enough to affect the person in a lot of aspects of their daily life.

It is very difficult, if not impossible, to predict how badly a person is going to be affected while they are still sedated or otherwise unwell. Although CT and MRI scans can show that there has been some damage, the scan appearances correlate very poorly with the clinical outcome - so, for example, one person might have quite extensive changes on scans but be only very mildly affected, whereas another might have minimal changes on the scan but have more severe problems.

There are all sorts of other factors that can affect the way the brain functions and can make it more difficult to assess the level of damage. The presence of infection, kidney failure (I remember you mentioning at one point that Holly-Anna was needing dialysis?), the use of sedatives and other drugs and persisting low oxygen levels can all make people appear to be more severely affected than they are. Sedative drugs can often take several weeks to clear the system completely after they are stopped, and withdrawal of these drugs can also cause confusion and other problems. It is very very common for a patient who has been in ICU for some time to display a range of problems including confusion, disorientation, paranoia, poor concentration and memory, and physical difficulties such as poor coordination and balance, all of which could be due to hypoxic brain injury, but could equally well be due to many other factors which will gradually resolve.

If there is significant hypoxic brain injury, this will usually become apparent over the weeks and months following recovery from the initial illness. Symptoms, as I have said, are very dependent on the area and extent of the damage and can range from emotional difficulties such as labile, quickly changing emotions, difficulty in controlling emotions, anxiety and depression and change in personality, to physical difficulties such as problems with vision and speech, balance and coordination. Again it's important to stress that this symptoms can also result from other ICU related problems which may well resolve completely given time.

Assessment of hypoxic brain injury or any other brain injury is usually done by several members of the hospital team, including physios to look at physical coordination, balance etc, Occupational Therapists who will assess memory and cognitive skills, doctors, nurses, Speech and Language Therapists, etc etc. If the brain injury is severe enough to require specific rehabiliation, this will often be done in a specialist Neuro-rehabiliation centre, where they are expert in helping people make the optimum recovery from something like this. I have briefly worked in a place like that, and they are amazing in the work that they do and the results which they achieve. I have seen patients come in with really quite profound difficulties (some of whom were initially thought to have non-survivable brain injuries) and make a tremendous improvement, sometimes getting back to work and to an independent life.

In terms of the asthma side of it, hypoxic brain injury caused by an asthma attack is treated in the same way as any other - with, of course, extra focus on managing the asthma as best as possible and trying to avoid any further hypoxic episodes.

You can find more information about this on the internet, but be careful, as there are a lot of sites out there offering information which is sometimes not correct, as well as a whole range of 'miracle cures' which are dubious to say the least. The organisation Headway, which is a support organisation for all types of brain injury, offers excellent information and support - you can find them at headway.org.uk

On a personal note, as you may know I have brittle asthma and have had some pretty severe attacks in the past. My husband and family have been told on several occasions that some degree of brain damage from hypoxia and/or profoundly low blood pressure was likely. The first occasion that this happened was nearly ten years ago; at that time one of my pupils had dilated, which was felt to be a sure sign that something fairly devastating had happened in my brain. On another occasion about three years ago, when I had had hypoxic seizures prior to intubation, I woke up with loss of part of my visual fields, inability to read and a perception problem called finger agnosia, all of which resolved over the course of a few days.

On the occasion of my last illness, in Feb - March of this year, I had several seizures, and CT scan did show some areas of change in my brain which were attributed to small strokes from persistantly low sats and blood pressure. Again my family were warned that some degree of damage was likely. I cannot really comment on whether there has been any personality change etc, as it's not really something you can assess yourself, but my family assure me that I am still the same person! After the first episode I went on to get a medical degree, so cognitively there can't have been too many ill effects. Now that I am not working I have fewer day to day intellectual challenges, but I am heartened by my ability to still do the Deadly level Suduko puzzles (I am sorry if that sounds flippant, it is not intended to! They are really good as brain trainers - they are even used in some of the rehab centres for that purpose) so I think I have come through the whole experience relatively unscathed.

I have spent many hours post-ICU attacks torturing myself with the possibility that I might have sustained some sort of damage - worrying about symptoms such as emotional lability with easy tearfulness and anger, low mood, poor concentration and memory problems. All of these, quite apart from any physical effects of drugs used, can be attributed to the stress and anxiety induced by the experience - a sort of Post-Traumatic Stress Disorder, which is almost inevitable after such an experience. All of those sorts of symptoms gradually resolved.

If there is one thing that I have learnt over the last few months, it is that the human body and brain are amazingly resilient, especially if you are young, and that situations which can seem incredibly bleak can end well. So take heart, don't give up hope, and give it time - it is very early days really and things may well turn out a lot better than you fear.

You, Holly-Anna and your family are very much in my thoughts and prayers. Feel free to PM me at any time if you have any more questions or just want to chat or let off steam.

Look after yourself. Hope this helps

Em H

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thank you both for the time and effort with my questions. you will never realise how truly grateful i am for everyone's response during this time, since Hollyanna has been unwell. I have no real words to express my true gratitude to you. Emily and Andrea THANK YOU. love Jaycie