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Diffused Axonal Injury - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2009
Answered : 654 Questions
Doctor :   hi
Doctor :  
how can i help you?
Doctor :  
please proceed with your health query
User :   One of my very close relative had a motor cycle accident on 23rd November 2009. He is diagnosed to have been suffered from Diffused Axonal Injury. He is in Coma right from the time of the accident. Doctors have assessed his GCS to be in the range of 5-6. Trying to open the eye lids but can't do that. Some response to light in the right eye, not much in the left eye. He can react to pains. When he is being suctioned or new saline channel is being done, he jerks his upper part of the body. Also some movements of the legs and hands are observed. He has four small blood cloting in the brain including one in the center. He has been taken out of ventillation from the 8th day. He can sustain the respiration well (oxygen consumption is around 2 liter). He is maintaining the vitals pretty well right from the begining. He is also a pretty strong built man of age 44 years. No surgery of brain has been carried out. Also not much of treatment apart from life support and antibiotics.

Can any one please tell me about the chances of coming back from coma? If there are chances, how long it GENERALLY takes? I would appreciate if you can please help or refer me to some better web site, where I can more relevant information.
Doctor :  
please give me sometime to read through your history
User :   sure Doc
Doctor :  
ok
Doctor :  
do you know what medications they are giving to him now?
User :   They are giving antibiotics and some neuro vitamin supplements

Doctor :  
ok
Doctor :  
is there any treatment for th eclots being given?
User :  
no, the neuro surgeon who is treating said that there is no specific medicine or surgery that can help on DAI. It will heal natuarally
Doctor :  
it takes a very long time to heal naturally
User :   is there any medine that can help?

Doctor :  
i will provide you a link where you can read up more on it, and then discuss the probable outcomes for the patient.
Doctor :  
WWW.WWWW.WW User :  
ok
Doctor :   the treatment of this involves a mutiple approach from various branches of medicine
Doctor :  
including speech therapy, physical therapy, occupational therapy, counselling, adaptive equipment training, and recreational therapy
Doctor :   if the clots in brain are too big and extensive bleed is there, then the blood thinners called heparin or warfarin are given
Doctor :  
have you followed what i have said?
Doctor :  
are you there?
Doctor :  
are you there?
User :  
Yes was reading the page you have referred
Doctor :   ok
User :  
Yes. Doctor told that swelling is not happening as otherwise it would have impact the vitals
Doctor :  
is there anything else i can help you with?
Doctor :   ok
User :  
Now can we assume that survival is not in question?
Doctor :  
usually the pateints recovery is questionable
Doctor :  
90% of the patients remain unconsious
User :  
Yesterday he had some infection causing the TC to be raised to 0000 and Urea count to 40
Doctor :  
ok
User :  
You mean 90% of these kind of patients those who survive reamins unconciuos forever?
Doctor :  
these complications need to be treated
User :  
Yeas Doc has changed the antibiotics
Doctor :  
yes, the mostly go into 'vegetative state'.
Doctor :  
and 10% of them who regain consciousness after the therapies, are often severely impaired.
User :  
so - are we leading to a worse condition than his death?
Doctor :   it takes a very long time to recover if they do recover, it needs lot of patience and involving different modalities as i have mentioned earlier.
Doctor :   he needs to be treated for the infections
User :   Yes. he is being trated.

Doctor :  
and stimulated well from all spheres of therapies in a co-ordinated manner to be able to help him out
Doctor :  
also the Diffused Axonal Injury is of two types.
Doctor :  
Grade I and Grade II
Doctor :   depending on the grade of the Diffused Axonal Injury, the recovery will also matter
User :   It is definitely one of the most severe form - I don't know if it Grade I or II

Doctor :  
ok
Doctor :  
i suggest you discuss with the treating doctor for more details
User :  
What grade do you think it should fall under?
User :  
Apart from heparin or warfarin - do you suggest any other medication at this stage?
Doctor :  
and ask the prognosis of the recovery , he wil be able to answer you better as to how his progress is and how long he might take to recover
User :   He said wait and watch...

Doctor :   at present there is no specific treatment for this
Doctor :  
we have to wqait and watch
Doctor :  
giving him symptomatic treatment
Doctor :  
and also supportive therapies.
User :  
ok
Doctor :   is there anything else i can help you with?

User :  
is there any neuro speciakist in your panel whonm i can talk to?
Doctor :  
ok
Doctor :  
yes, there is a neurologist
Doctor :  
do you want to take second opinion?
User :   yes please
Doctor :  
just give me a moment
User :  
sure
Doctor :  
WWW.WWWW.WW Doctor :   visit here to place your request for second opinion.
User :   Thanks Doctor for your advise

Doctor :   Is there any thing else I can help you with?
User :   That's fione. Doc. Thanks for your help.

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Doctor :   hi
Doctor :  
are you back?
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how can i help you?
Doctor :  
is there anything else i can help you with?
Doctor :  
are you there?
User :   Yes. Doc. I tried to avail the service to call the doc. Paid through credit card. But the page didn't load. Shall the doctor be informed about my question?
Doctor :   ok
Doctor :  
you will need to put a request for the second opinion
Doctor :  
our CRM team on recieving your request will help you
User :  
Yes. I paid 899 INR, but the page didn't load
Doctor :  
in either getting a call from the specialist or a e-mail from the specialist
Doctor :   what is the error message that you are getting?
Doctor :  
please confirm your contact details, phone number and e-mail ID
User :  
From the payment gateway it said that it will redirect me to the requesting website. Then got the error page couldn't load
Doctor :  
one of our customer care executive will call you up to help you out in this matter.
User :  
That will be great. Thanks for your help.
Doctor :  
shortly you will get a call
User :   Thanks Doc

Doctor :  
please confirm your phone number
Doctor :   Please fill the feedback form say done when done
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
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