Skull brain trauma: Permanently permanent damage

Different complications threaten the life of Michael Schumacher despite recognizable improvements

03.01.2014

Michael Schumacher has been in coma with a traumatic brain injury( SHT) for four days. Its survival chances are rising, but the risk of permanent damage to the brain remains. In a ski accident, the former Formula 1 world champion had seriously injured his head despite his helmet and then fell into a coma on the way to the clinic.

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At the fall, Schumacher had bounced with his head against a rock and had suffered a severe traumatic brain trauma. Although the former Formula One driver was still conscious until the arrival of the rescue service, he subsequently fell into a coma and has not since then re-awakened. The computer tomography of the skull showed, according to the doctors, clear bruises and bruises in both brain halves. Although the doctors succeeded in stabilizing Schumacher's condition in two surgeries, they already reported a slight improvement in his condition, but still no all-clear can be given. In addition, permanent damage and disability are not uncommon in such serious injuries to the brain.

Increasing survival chances
The neurosurgeon Andreas Pingel, head physician of the Center for Spinal Column Surgery and Neurotraumatology at the BGU in Frankfurt, told the news magazine "Focus" that "the first three to five days are the most critical"is still too early to give a forecast. But the survival chances of Schumacher would increase every hour. However, a longer coma could also cause additional complications. For example, "long-term breathing is a risk of lung inflammation. In addition, the nerves in the arms and legs can be damaged, "explained Pingel. In patients who are in coma for more than two weeks, the risk of muscle wasting is increased and there is a risk of disturbed nerve water circulation. The latter may cause the brain chambers to fill with water.

Long-term effects in the case of cranial brain trauma
According to the "Focus", about 2,000 patients are treated with a traumatic brain trauma annually, about a quarter of which are as serious cases as Schumacher. Of those affected, scarcely one-third survive the severe cerebral brain trauma. Even patients who are in an acute state often show severe damage and disability, the neurosurgeon continues. Pingel speaks of only "ten to 30 per cent of the survivors" who can then live with tolerable limitations."As a rule, patients start from scratch and have to learn the simplest things like eating and drinking," the specialist emphasized. In view of the drastic consequences that such injuries may entail, physicians who advise the risk of serious falls on the head are generally advised to wear a protective helmet. In the case of Schumacher, he had only allowed him to go to the hospital. Without a helmet Schumacher would probably have died directly at the scene of the accident.

coma the result of bleeding and edema in the brain
In approximately 25 per cent of the patients with such serious injuries as in the case of Schumacher, according to the expert, after the acute phase, a waking coma is established in which the patients open their eyes, but noneShow signs of a conscious perception and are not capable of communication. This state can theoretically last indefinitely. It is also typical for severe cranial brain traumas that the patients are still able to be approached directly after the accident and lose consciousness as soon as they are, as was the case with Schumacher, Pingel explained. The coma is the result of bleeding and edema in the brain. In the face of the missing place in the skull, these are increasingly pressing on the brain and the affected persons fall into a persistent unconsciousness. As in Schumacher, in such cases, the skull must be opened immediately to take the pressure off the brain. Corresponding cerebral hemorrhages and edema can also occur with a clear time delay to the event, which is why even with mild forms of SHT, clinical monitoring over several days is recommended.(fp)

Picture: Monika Torloxten / pixelio.de

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