Cerebral hypoxia or anoxia occurs when there is a break in the continuous supply of oxygen to the brain. This cut-off of oxygen leaves the brain unable to maintain its normal physiological functions that control almost all the processes going on inside the human body.
The brain needs a continuous supply of oxygen and without it can only survive for up to six minutes unless its supply is restored. Hypoxia and anoxia are used interchangeably, but hypoxia is when the oxygen supply to the organ is lessened, and anoxia refers to the complete absence of the oxygen supply to an organ.
This decrease or absence of oxygen supply may be due to rupture or blockage of a key blood vessel in the brain. Hypoxia further leads to the activation of a chain of biochemical and molecular events that continues this cycle of brain damage and ultimately leads to neuronal death.
Legal teams and case managers supporting clients living with hypoxic/anoxic brain injury should be aware of the range of causes – a number of events that interrupt oxygen supply to the brain. Mild cerebral hypoxia may occur in cases of asthma, ascent after deep diving and at high altitudes. Severe hypoxia is usually secondary to extreme trauma cases, such as suffocation, strangulation, choking, drowning and smoke inhalation. Carbon monoxide poisoning and drug overdose also contribute to severe brain hypoxia.
Other causes of decreased oxygen supply to the brain include cardiac arrest, irregular heart rhythm and very low blood pressure as seen during severe blood loss in trauma cases. Of these, cardiac arrest is seen to be the most common cause of hypoxic brain injury.
The symptoms of hypoxic brain injury may be mild or severe. Mild symptoms include loss of memory, paralysis, decreased attention and co-ordination. Severe symptoms like seizures, coma or even brain death can occur in cases of prolonged, severe cerebral hypoxia.
The sequence of events following a brain injury involves seizures, myoclonus, disorders of movement, dysfunction in cognition and other neurological abnormalities. Severe hypoxia can also lead to a prolonged disorder of consciousness, or coma, where may be able to open their eyes or make vocal noises, but they have no recognisable cognitive functions and are unable to respond to the people they are surrounded by.
Neurorehabilitation following hypoxic brain injury
The main goals of treatment in cases of cerebral hypoxia include both acute management of the patient and neurorehabilitation. Acute management involves stabilising the patient and treating any physical injuries. Later on, neurorehabilitation is required in order to resolve the long-term problems the person may face after brain injury.
This is achieved by a multi-disciplinary team, so that the best outcomes may be achieved in treating these long term complications. Improvement after brain injury depends on various factors like duration and severity of hypoxia. In cases of hypoxic brain injury, fast access to neurorehabilitation can lead to better outcomes for the patient.
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