Wednesday, 13 July 2011
Answered by: Dr Rajas Deshpande
M.D. (Medicine), D.M. (Neurology) Fellowship in Multiple Sclerosis (UWO Canada) Fellowship in Movement Disorders (UWO Canada) Consultant Neurologist
Q. My 41 years old relative had traumatic brain injury due to an accident last month. Since then he is in the vegetative state. MRI indicates acute infarction in bilateral superior cerebellum and diffuse axonal injury. His present status: eye response: open eyes with stimulation; not spontaneous, motor response: appreciable, verbal response: none. What are the chances of his recovery?
A. Traumatic Brain Injury may lead to most devastating complications.
When the head "bangs" against something hard, the soft "jelly-like" brain matter is shaken violently, and restricted by the fixed space within the skull bone. It can be compared to dropping a watermelon from a height: it is difficult to say which all parts within are injured or torn.
Diffuse axonal injury has three grades of severity depending upon which areas of brain it involves. After the immediate "shock" phase, the brain cells and their fibres attempt to regenerate, and the swelling gradually subsides. This may lead to significant recovery in the initial few months, which may continue for up to two years, although the maximum recovery is within first three months.
The recovery is definitely better with good supportive care, brain-tonic medicines, maintaining nutrition, and most importantly, good physiotherapy by a team of experts. Infections of any kind are to be carefully avoided.
Tall claims about stem cell transplant in traumatic brain injury are all unfortunately without any scientific evidence or approval, hence best neglected.
In your friend's case it is too early to comment about what the final outcome will be. What he gains at the end of three or four months may be what will be his permanent state.
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