An Overview of Anoxic Brain Injury: Causes, Symptoms, and Treatment

Anoxic brain injury, or ABI, is a non-traumatic brain injury that can be more specifically categorized as brain damage caused by a complete lack of oxygen to the brain. It is a closed brain injury where no physical penetration is required into the brain and which involves no breakage of the skull.

If the brain suffers from a deprivation of oxygen for a total of four minutes, the death of brain cells occurs and results in ABI. It may initiate in a human brain while suffering from a stroke, heart attack, near-drowning, choking incident, or secondary trauma to the head, which means that an initial trauma triggers the process of a specific secondary trauma over time.

ABI often causes loss of consciousness, short-term or long-term, and can subsequently induce a comatose state channeled through life-altering effects like paralysis, seizures, difficulty coordinating balance, vision problems, changes in sensory perception, trouble speaking and swallowing, changes in sleep pattern, lack of bowel and bladder control, changes in sexual function, motor impairment, and personality changes.

Symptoms and effects vary from case to case, so it is hard to project recovery and care. ABI can get worse over time, so a quick response in treating ABI is crucial.

What Causes ABI?

ABI is when there’s a lack of oxygen in the brain, which can cause permanent or temporary damage to the brain tissue. A lack of oxygen can occur from cardiac arrest, choking incidents, or trauma to the head. A primary difference between ABI and other types of brain injury is the time that elapses between the incident and the ultimate effects on the brain. Brain injuries caused by trauma or bleeding can happen almost instantly after the incident.

However, anoxic brain injury occurs over time as the brain gradually runs out of oxygen. For example, ABI caused by cardiac arrest occurs when a person’s heart stops beating, depriving the brain of oxygen. As such, ABI caused by cardiac arrest or near-drowning can be temporary or permanent, depending on the severity of the injury. On the other hand, ABI caused by choking incidents is usually temporary, as it occurs quickly, followed by treatment that restores blood flow to the brain. Other ABIs can be fatal if the victim does not receive immediate treatment.

What Are the Symptoms of ABI?

Depending on the severity level, the most common symptoms include headaches, seizures, coma, and paralysis. ABI has also been known to cause aphasia- a language disorder that causes a person to have difficulty speaking and understanding others; and apraxia- a motor skill disorder that causes a person to have difficulty performing movements (such as grasping objects or walking). Other prominent symptoms include seizures, mood changes, vision issues, etc.

How Do You Diagnose ABI?

A doctor must assess all people who suffer from ABI to determine the level of injury and prognosis. This includes a physical exam, blood tests, and imaging scans. Usually, an angiography (that tests the blood flow to the brain), an imaging test like a CT scan or MRI (where signs of stroke, bleeding in the brain, brain swelling, or other signs of injury are assessed), and an EEG (where electrical activity in the brain is measured) helps in the quick diagnosis of an ABI.

Doctors might also go for an Evoked potential test to find out the brain’s response to sensations like sight, sound, and touch. Certain factors that are important while a prognosis of an ABI is done include 1) the proximate cause of the ABI; 2) the time elapsed after ABI occurred; 3) the age of patient; and 4) the existence of other health issues.

What Are the Treatments for ABI?

ABI engulfs the brain and consumes the body over time, taking hours or even days to cause damage. Thus, the symptoms and effects might be avoided to some extent or in full if immediate medical attention and correct treatment are provided. Direct treatment of ABI is limited; however, the main purpose of quick medical response is to stabilize the body’s condition and resume adequate oxygen to the brain.

Treatments will vary depending on the type of injury, the severity of the injury, and the length of time before treatment starts. Treatment for ABI caused by cardiac arrest, near drowning, or choking will focus on preventing further injury, managing complications, and supporting the brain.

First, restarting the heart, restoring blood flow to the brain and, stabilizing pressure by mechanical support, preventing seizures and needs of oxygen in the brain using therapeutic hypothermia is important. Once the medical condition is stable, neurorehabilitation is necessary to re-adapt connections of the brain with the body for changed environment and other functions of the body.

In treatment for ABI caused by a traumatic injury, doctors will also focus on reducing swelling. Recovery from an ABI is a gradual process that is time sensitive and might be slower than expected.

Managing with ABI

As ABI can drastically affect a patient’s motor and sensory nerves, it can temporarily or permanently damage a person’s daily locomotor ability, which makes the patient dependent on a person to do basic activities. This can be a traumatic, isolating, and frightening experience for the injured person and loved ones.

Apart from what can be done in equipped hospitals and by trained doctors, before or after the treatment, a patient’s family can play a crucial role in managing such a patient. Involving various professionals like an occupational therapist who helps in developing and regaining daily life skills, a physical therapist who helps improve motor skills, etc., a speech therapist who might help regain speech and recover from any language disorders, and a neuropsychologist who may assess the emotional and behavioral issues and act accordingly. Reaching out to others for support and information about resources can help.