Can the Brain Recover from a Hypoxic Brain Injury?
The answer depends–hypoxic (and anoxic) brain injuries often result in serious and permanent injury. However, proper treatment can help minimize the damage and manage symptoms caused by the brain injury. In this sense, a recovery is sometimes possible.
This information was compiled from government sources, educational non-profits, and medical experts.
To learn more about recovery from hypoxic brain juries, keep reading.
Hypoxic and Anoxic Brain Injuries Explained
The brain relies on a steady flow of oxygen (and glucose) for energy. Without energy, the cells in the brain will begin to die. Cells in the brain that die do not regenerate, therefore injuries that cause cells in the brain to die often cause permanent negative conditions.
In a healthy body, blood delivers oxygen to the brain. When oxygen delivery to the brain is completely cut off, an anoxic brain injury occurs. When oxygen to the brain is partially cut off, a hypoxic brain injury occurs.
Anoxic brain injuries are commonly caused by cardiac arrest and can often result in serious conditions such as a prolonged coma, permanent cognitive deficits (if the patient survives), and death.
Hypoxic brain injuries are also often quite serious, but can sometimes respond better to treatment.
Throughout the rest of this article, the discussion will focus on hypoxic-ischemic brain injuries, including what can be done to recognize them, treat them, and prevent them.
Pathophysiology of a Hypoxic Brain Injuries
Tip: Pathophysiology means: “the study of the disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury.” In other words, it’s the study of the condition and of the mechanisms operating within the person.
The human brain requires a constant supply of energy to function optimally. Normally, the brain is supplied with energy by glucose and oxygen. When the supply of oxygen to the brain is disrupted, the brain still demands energy. Decreased oxygen means less energy, which leads to cell death.
Histopathology of Hypoxic Brain Injuries
Tip: Histopathology means “the study of changes in tissues caused by disease.”
There are two ways that cell death in the brain occurs: through necrosis and through apoptosis. Necrosis is when a cell dies prematurely and apoptosis is when a cell self-destructs through the body’s normal self-regulating processes.
When brain cells cannot get the energy they need, brain cells begin dying. This is known as necrosis. As the cells die, they release chemicals and free radicals that can damage other cells. This chain reaction leads to a second wave of brain cell deaths that can occur hours later.
One way to think about these complicated events in the brain is to think of a large bomb detonation. There is the initial damage done by the blast itself, then there is a secondary wave of damage done by the shockwave and shrapnel expanding away from the blast.
Similarly, the damage caused by lack of oxygen in the brain is often not limited to just the initial damage, but also includes a secondary wave of damage.
Treatment of Hypoxic Brain Injuries
One common method for treating hypoxic brain injuries is to artificially cool the body’s temperature.
Cooling the body shortly after a hypoxic brain injury will not necessarily undo damage that the brain has already suffered. However, cooling the brain may slow down the biochemical and molecular events that cause additional brain damage following the initial injury.
Because of the risk of permanent and serious brain damage associated with hypoxic brain injuries, the best treatment of all is prevention.
In cases with infants, medical professionals are uniquely well positioned to carefully monitor the baby’s heart rate and other vital signs. If the baby shows signs of a potential hypoxic brain injury, such as sudden accelerations or decelerations of the heart, medical professionals should be prepared to deliver the appropriate care to try and prevent a hypoxic brain injury. In many cases, this can mean ordering an emergency c-section to deliver the baby.
Failing prevention, medical professionals should be prepared to try and minimize and prevent ongoing and future damage. In many cases this means applying cooling therapy.
Prognosis of Hypoxic Brain Injuries
The prognosis for patients who suffer a hypoxic brain injury can be difficult to predict. While some patients may seem to make a full recovery, the full effects of a brain injury are often not known until sufficient time has passed to observe the patient.
In cases with infants, it can be especially difficult to know the full effects of a brain injury and sometimes the effects are not known until years later. Parents may have to wait years to observe whether the child achieves normal developmental milestones, then seek additional screenings and tests, all before having a full picture of the child’s health.
Other complications associated with hypoxic brain injuries include seizures, movement disorders (like Cerebral Palsy), cognitive impairments, hearing and vision loss, and more. In severe cases of brain injury, these complications may be obvious immediately. However, in other cases, these complications may only become apparent over time.
Once cell death in the brain occurs, there is no recovery in the sense that the cells do not regenerate. However, with proper treatment, further damage and complications may be prevented.
Furthermore, obtaining an appropriate treatment plan can help patients manage short and long term conditions caused by hypoxic brain injuries. In this sense, many patients can eventually recover from a hypoxic brain injury.
Lacerte, M., & Mesfin, F. (2020). Hypoxic Brain Injury. Statpearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537310/
Learn about Anoxic and Hypoxic Brain Injuries. (2020). Shepherd.org. Retrieved 19 May 2020, from https://www.shepherd.org/patient-programs/brain-injury/about/types-of-brain-injury/anoxic-hypoxic-brain-injury
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