Traumatic brain injury: permanent damage



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Despite noticeable improvement, various complications threaten Michael Schumacher's life

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

During the fall, Schumacher had hit his head against a rock and had suffered a severe traumatic brain injury. Although the former Formula 1 driver initially remained conscious until the emergency services arrived, he subsequently fell into a coma and has not woken up since. Computed tomography of the skull clearly showed bruises and bruises in both hemispheres of the brain, according to the doctors. Although the doctors managed to stabilize Schumacher's condition in two operations and reported a slight improvement in his condition, the all-clear cannot yet be given. In addition, permanent damage and disabilities are not uncommon with such severe brain injuries.

Increasing chances of survival Neurosurgeon Andreas Pingel, senior physician at the Center for Spinal Surgery and Neurotraumatology at the BG Accident Clinic (BGU) in Frankfurt, explained to the news magazine "Focus" that "the first three to five days are the most critical" and it is therefore still too be early to make a forecast. But Schumacher's chances of survival would increase every hour. However, a longer coma could also cause additional complications. For example, “Long-term ventilation poses a risk of pneumonia. It can also damage the nerves in the arms and legs, ”explained Pingel. Patients who have been in a coma for more than two weeks also increase the risk of muscle wasting and the risk of disturbed nerve water circulation. The latter could result in the brain chambers filling up with water.

Long-term damage to traumatic brain injuries According to the "Focus", around 2,000 patients with a traumatic brain injury are treated at the doctor's clinic, with around a quarter of these cases being as severe as with Schumacher. Almost a third of those affected do not survive the severe traumatic brain injury. Even patients who survive the acute condition often show severe damage and disabilities, the neurosurgeon continues. Pingel speaks of only "ten to 30 percent of the survivors" who can then continue to live with tolerable restrictions. "As a rule, the patients start over and have to learn the simplest things like eating and drinking again," emphasized the specialist. Given the drastic consequences that such skull injuries can bring, medical practitioners generally recommend wearing a protective helmet for sports that involve the risk of serious falls on the head. In the case of Schumacher, he made it possible for him to make it to the hospital. Without the helmet, according to the doctors, Schumacher would probably have died directly at the scene of the accident.

Coma the result of bleeding and edema in the brain According to the expert, around 25 percent of patients with such severe injuries as in the case of Schumacher develop a coma after the acute phase, in which the patients open their eyes but show no signs show conscious awareness and are unable to communicate. This state, theoretically, can last indefinitely. It is also typical of severe traumatic brain injuries that the patients can still be addressed immediately after the accident and only lose consciousness at a later time, as was the case with Schumacher, explained Pingel. The coma here is the result of bleeding and edema in the brain. In view of the lack of space in the skull, these press increasingly on the brain and those affected fall into a constant loss of consciousness. In such cases, as with Schumacher, the skull had to be opened immediately in order to relieve the pressure on the brain. Corresponding cerebral hemorrhages and edema can also occur with a significant time delay to the event, which is why clinical monitoring over several days is recommended even in the case of mild forms of TBI. (fp)

Image: Monika Torloxten / pixelio.de

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