Brain damage as a result of stroke or traumatic brain injury can have a wide variety of outcomes, from a complete recovery to brain death. There are some prognostic factors that are indicative of serious brain injury, with little chances of recovery.
Long-Term Mechanical Ventilation
If a person cannot breathe on their own, mechanical ventilation is necessary to provide them with oxygen. The medical staff may periodically test the patient's ability to breathe on their own when assessing their neurological status, and possibly whether the person can be declared brain dead. In some cases, a person who once required mechanical ventilation may eventually breathe on their own. Sometimes this occurs if the reasons for mechanical ventilation is injury to the lungs or trachea.
In the case of brain injuries, mechanical ventilation may be necessary if there is damage to areas of the brain that are responsible for involuntary actions, such as breathing. Seeing a loved one with significant brain injuries "breathing" can create the facade that they are not gravely ill. Without ventilation, the person would stop breathing, often within minutes or hours. Additionally, long-term mechanical ventilation is not without its own risks, such as the development of pneumonia.
Limited Or Abnormal Response To Pain
Response to painful stimuli is a innate response; even if a person cannot verbalize their response, they will normally pull away from the pain or try to push the stimulus away. Medical professionals may use a fist to vigorously rub the center of an unconscious person's chest or squeeze their nail bed to elicit a response. People with significant brain damage may have no response to these stimuli, or they may have an abnormal response. Abnormal responses to pain include posturing, such as decerebrate or decorticate posturing. Both types of posturing, whether in response to pain or if the person remains in that position without any stimulus, are signs of significant damage of critical brain structures.
Eye Movements
Eye movements in people who have a serious brain injury can be deceptively positive to their loved ones. Many people who have a poor prognosis may not open their eyes at all or will open their eyes and look around. They may have sleep/wake cycles, shed tears, or even have the appearance that they are looking around the room. Unfortunately, this behavior is often not in response to a stimuli or the voice of a loved one, it is simply involuntary movements that do not mean the person is getting better or is aware of their surroundings.
Neurological assessments are imperative for gaining a better idea of the prognosis for those affected by serious brain injuries. Results of these tests can you make the right medical decisions for your loved one. To learn more, contact a medical facility like Brain Matters Research.
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