Anoxic Brain Injury – Causes, Symptoms & Diagnosis

Thinking without the brain is impossible in this world. In the human body, the brain is an essential organ that regulates emotion, thought, memory, motor skills, touch, vision, breathing, temperature, hunger, and many other processes. There are many issues with the brain that are caused by different causes, like genetics, illness, or injury. Each brain issue has various risks, diagnoses, and treatments. Let’s have a look at the anoxic brain injury.

What is Anoxic injury?

Anoxic brain injury refers to a condition in which there is a complete lack of oxygen in the brain, which leads to brain cell death approximately after four minutes of oxygen absence.

A regular supply of oxygen is needed for your brain to work properly and survive. If something disturbs or stops the oxygen flow to your brain for 3 minutes or longer, then the brain cells start to die. This will cause serious and permanent brain damage in a few cases. 

Difference between Anoxic and Hypoxic Brain Injuries

If the oxygen supply is fully stopped and no oxygen goes to the brain, then it’s called anoxic brain injury or cerebral anoxia. But if your brain acquires less oxygen flow for some minutes, then you may have another condition called hypoxic brain injury or cerebral hypoxia. In a few cases, the two terms are interchangeably used or otherwise used together as hypoxic-anoxic brain injury.

What is the result if your brain lacks oxygen?

The brain uses a maximum of one-fifth of your body’s oxygen supply. This oxygen supply is used by it to send nerve signals that help your body function properly. But if the oxygen supply is reduced or cut off, then the brain cells start to die. If the brain stays without oxygen for a longer period of time, then it could lead to brain death or coma.

Causes of Anoxic Brain Injury

Anoxic brain injury is caused by the lack of oxygen in the brain. The factors that cause your brain to not get enough oxygen include:

• Cardiac arrest
• Heart attack
• Irregular heart rhythm (arrhythmia)
• Choking
• Suffocation
• Low blood pressure due to blood loss or poor heart function
• Strangulation
• Serious asthma attack
• Risks due to general anaesthesia during surgery or other medical procedures.
• Drug overdose
• Electric shock
• Breathing in the smoke
• Breathing in carbon monoxide
• Near drowning
• Exposure to high altitudes
• Poisoning, like carbon monoxide
• Seizure
• Stroke
• A head injury, like a traumatic brain injury from blunt force, could be due to falls, gunshot wounds, car accidents, injuries at work, or sports injuries.
• Lung disease

Symptoms of Anoxic Brain Injury

When you lack oxygen, within 15 seconds, you’ll usually lose consciousness. Other symptoms of Anoxic brain injury include :

• Confusion
• Slurred speech
• Trouble forming sentences
• Feeling disoriented
• Facial drooping
• A bluish or greyish-coloured tint to the skin and lips
• Shallow breathing
• Fast breathing
• Dilated pupils, i.e., the black centres of your eyes, are larger than normal.
• Hardness in responding to a name
• Trouble squeezing the hand
• Seizures

Diagnosis of Anoxic Brain Injury

In general, the doctor will check if there is a brain injury due to oxygen lack at an early stage or on arrival at the hospital. They confirm the result after they hear information about what happened or what might have caused it. For the diagnosis, your doctor will recommend some tests to evaluate brain function and check the seriousness of the damage. 

1) Angiography

Angiography is a kind of X-ray used to check blood vessels; it will test the blood flow to the brain. For this test, a particular dye known as a contrast agent will be injected into your blood to get a clear X-ray view. This is because the blood vessels will not show up clearly on a normal X-ray. 

2) Imaging tests

The doctor might recommend either a CT scan or an MRI. The doctor will check if the patient has symptoms of stroke, brain swelling, bleeding in the brain, or other signs of injury. 

CT Scan – A computed tomography scan, also called a CT scan, is a medical imaging procedure that is used to get detailed internal images of the body.

MRI Scan – Magnetic resonance imaging, also called MRI scanning, is a medical imaging procedure that is used in radiology. It helps capture images of the anatomy and the physiological processes inside the body. The scanners in this scan use the features of strong magnetic fields, magnetic field gradients, and radio waves to create pictures of the organs in the body. 

3) Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test in which electrical activity in the brain is measured. This electroencephalogram (EEG) is a test for recording brain activity. An electroencephalogram is a painless test in which small sensors are connected to the scalp to collect the electrical signals generated by the brain. 

4) Evoked Potential tests

Evoked Potentials tests help measure your brain’s response to mild electrical stimulation in many parts of your body. These tests help diagnose the brain’s response to sensations such as sound, sight, and touch. They also measure the velocity of the messages from sensory nerves to the brain. In some cases, evoked potential tests are used to diagnose MS. This is because they are non-invasive, painless, and faster than MRI scans.

Treatment of anoxic brain injury

The diagnosis of an anoxic brain injury is possible at an early stage after collecting the details of the patient’s condition on arrival at the hospital.  The treatment will depend on the particular circumstances based on the various causes of anoxia. The healthcare providers will make an effort to bring back a normal heartbeat, a good supply of oxygen to the brain, and blood pressure. 

A patient with a serious anoxic episode will be admitted to an ICU, mostly in a specialist neurosciences centre. The patient might be given drugs to maintain their blood pressure and normal heartbeat.

Generally, many people get seizures after an anoxic brain injury, which is sometimes hard to control. This critical stage needs the full range of intensive care to give the best chances of survival and the best results. A seizure is an uncontrolled burst of electrical activity in the brain, which could result in changes in behaviour, movements, consciousness,  and feelings.

In a few centres, patients might get medically induced cooling, called therapeutic hypothermia. It may offer a protective effect on the brain and aid recovery by lowering the oxygen and energy needs of brain cells. Therapeutic hypothermia is a treatment that helps reduce the body temperature, thus reducing injury and long-term issues. However, therapeutic hypothermia could cause issues like an increased risk of infection or interference with blood clotting.

Treatment for anoxia involves establishing an adequate airway, using sufficient oxygen to saturate the blood, assisting the cardiovascular system, controlling seizures (in some cases), and preventing or treating pneumonia.

What to avoid after a brain injury?

You must avoid some activities after the brain injury to safeguard yourself from further risks. You need to follow the below steps after a brain injury :

• Sleep for enough time or have enough sleep at night.
• Have rest during the day.
• Do not perform physically demanding activities like working out, heavy housecleaning, weightlifting, etc.
• Do not perform tasks that require a lot of concentration, like balancing your chequebook. This is because these activities could worsen your symptoms and slow down your recovery.

Best Foods for Brain Injury Recovery

Some foods help with brain injury recovery. Those foods that help in brain injury recovery are given below:

1. Dark Chocolate

A large amount of magnesium and antioxidants are present in dark chocolates. These nutrients help maintain a healthy brain and aid in TBI recovery. But the benefits of dark chocolates are extraordinary and must be eaten in moderation because they also contain some processed sugars, which must be limited for brain injury recovery.

So, you can opt for dark chocolates with high percentages of cocoa instead of ones that contain processed sugars. 

2. Fatty fish

Some fish contain high levels of omega-3 fatty acids, which help with brain injury recovery. This is due to the fact that most of the brain is fat, and more of its fat content is omega-3 fatty acids. So, fatty fish help fuel the brain’s recovery.

The brain uses omega-3 to reconstruct the brain cells, which is necessary for preserving the brain’s plasticity, or its capability to adapt. Neuroplasticity is a central component of TBI rehabilitation, so eating Omega-3 helps promote brain repairs.

A few fish with omega-3 fatty acids are :

• Salmon
• Sardines
• Mackerel

3. Flaxseed Oil

Flaxseed oil contains omega-3 fatty acids, so it can be added instead of fish. Much of the omega-3 found in flaxseed oil cannot be used without being converted into a usable form, but flaxseed oil could be added to one’s diet.

As the omega-3 found in flaxseed oil is not as high as the omega-3 found in fish, it is better to eat them in larger quantities, but only as per the doctor’s recommendation.

4. Dark and leafy greens

Dark leafy greens like kale and spinach are good to be added to the diet of survivors of brain injuries. Leafy greens have high levels of omega-3, which is needed for the brain. Kale contains B vitamins, which improve communication between brain cells and help neuronal repair after TBI. Kale can be added to a person’s diet if he or she is surviving a head injury.

5. Eatable Seeds

Walnuts and pumpkin seeds contain Omega-3. Also, the walnut skin contains antioxidants, which help lower inflammation and boost brain recovery. Pumpkin seeds also contain omega-6 fatty acids. However, more omega-6 increases inflammation, which is not good for brain injury recovery. So, eat a very small amount of pumpkin seeds.

Seeds like squash seeds and sunflower seeds help reduce cholesterol and blood pressure. They help the patient after the head injury. Make sure that you do not eat the poisonous seeds.

6. Berries

Berries contain antioxidants, which help protect against brain damage and lower inflammation. Some berries, like strawberries and blueberries, help improve memory, learning, and other cognitive functions. The health benefits of blueberries are amazing and it helps to increase the production of BDNF. This helps trigger the brain to repair brain cells and create new brain cells through a method called neurogenesis. 

7. Eggs (and avocados)

Eggs contain choline, which helps create the neurotransmitter acetylcholine. The neurotransmitter acetylcholine helps with mood and memory.

8. Avacado

Avocados contain oleic acid, which helps the brain  execute the information quickly.  For better benefits, you can combine eggs with avocados to give the brain a better cognitive boost.

9. Meat

Eating meat helps increase protein intake and zinc. Zinc helps the immune system and the formation of memories. Zinc is needed during brain injury recovery because zinc levels get depleted in the brain after a head injury. Red meat contains zinc, but as it is processed, it is also linked with an increased risk of heart disease. So, eat only less processed red meat.

10. Legumes

If you have heart disease, you must avoid meat products; instead, you can take other protein and zinc sources. Legumes like chickpeas and lentils provide zinc, which helps recover from brain injury.

11. Turmeric root or powder

Turmeric contains a rich source of curcumin, which benefits TBI survivors. Curcumin is an antioxidant; it stimulates the production of BDNF, which is needed for the brain. BDNF helps with the neuronal repair and regeneration necessary for brain injury recovery. Thus, the yellow-coloured spice turmeric helps with brain injury recovery.

Conclusion

Anoxic brain injury refers to a condition in which there is a complete lack of oxygen in the brain, which leads to the death of brain cells approximately after four minutes of oxygen absence. Cardiac arrest, heart attack, irregular heart rhythm (arrhythmia), choking, and suffocation are some of the causes of anoxic brain injury.

Confusion, slurred speech, trouble forming sentences, feeling disoriented, facial drooping, etc., are the symptoms of anoxic brain injury. Angiography, imaging tests, EEG, etc., help diagnose anoxic brain injury. The treatment for anoxic brain injury depends on the condition of the injury and its seriousness.

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