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What are the chances of brain damage due to lack of oxygen?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Answered by

Neurologist
Practicing since : 1994
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Question
44 yr old male massive heart attack no oxygen 20 minutes put in heart stent in icu cannot drop tempreture constant seizures oxygen support other organs normal survival success / rate if any brain damage ? What to expect ?
Posted Wed, 20 Aug 2014 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 9 hours later
Brief Answer:
High chances of severe brain damage.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted the details. Based on the description, there are very high chances of significant brain damage due to lack of oxygen (hypoxia) and blood supply (ischemia) to brain. This condition is called as hypoxic-ischemic encephalopathy (HIE).

Presence of seizures indicate that the brain damage is severe, and a survival with normal brain functions is unlikely.

The extent of brain damage can be further assessed with electroencephalogram (EEG) and evoked potential studies.

In the meanwhile, anti-epileptic drugs and other supportive treatment should be continued.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by
 
Follow-up: What are the chances of brain damage due to lack of oxygen? 6 minutes later
Hi doctor thanku seizures have stopped will he awake and survive with brain damage can hospital turn off oxygen support if he doesnt wake if he does what state will he likely be in
 
 
Answered by Dr. Sudhir Kumar 4 minutes later
Brief Answer:
EEG can help.

Detailed Answer:
Thank you for getting back.

Stopping of seizures is a good sign.

Is he conscious or in coma?

Oxygen support can only be turned off if he is "brain dead". This information can come from EEG. I think EEG should be done as early as possible to know the status of brain.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: What are the chances of brain damage due to lack of oxygen? 3 minutes later
He is in induced coma they put him to sleep to control seizures brain tests have shown some activity there now trying to control tempreture he is under cold blanket what is most possible outcome can they reduce oxygen as they have said we are going to give hom another 24 - 48 hours what will be the next strep
 
 
Answered by Dr. Sudhir Kumar 4 minutes later
Brief Answer:
Clinical picture and EEG would help.

Detailed Answer:
Thank you for getting back.

They would stop all sedating drugs and look for brain functions. This would include any response to painful stimulus and verbal calls. Also, pupil size and reaction, eye movements, cough reflex, blood pressure and any spontaneous breathing, will all help. If there is any positive response in the above clinical findings, the oxygen support would be continued.

If there is no response in the above tests, then, EEG and other tests (apnea test, cold caloric test) would be done to assess for brain death. If the tests confirm brain death, only then oxygen supports would be withdrawn.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: What are the chances of brain damage due to lack of oxygen? 14 hours later
Thry have diagnosed myoclonus and want to withdraw life support is this brain death can they do this very urgent plsss
 
 
Answered by Dr. Sudhir Kumar 1 minute later
Brief Answer:
Received and replied.

Detailed Answer:
Thank you for getting back.

I received the last question 14 hours back and have already replied to that, as can be seen above.

If you have any more query, I would be pleased to answer.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: What are the chances of brain damage due to lack of oxygen? 6 hours later
Plsss answer question regarding myclonus as per above if we take him home can he be treated only support from hospital is ventilator and drip is myoclonus sufgicient reason to withdraw life support URGENT
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
Myoclonus does not mean brain death.

Detailed Answer:
Thank you for getting back.

Myoclonus does not mean brain death, however, it indicates severe brain damage.

Decision to withdraw life supports would depend on other reports such as EEG, evoked potential studies and patient's likelihood of improvement in future.

This can be discussed with the treating neurologist.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: What are the chances of brain damage due to lack of oxygen? 1 hour later
Is there a chance if any improvement / recovery in the future
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
Need some more information.

Detailed Answer:
Thank you for getting back.

I need some more information to predict the chances of recovery. These are:

1. Neurological examination findings, especially Doll's eye movements, motor response.

2. EEG report.

3. CT/MRI scan of brain if available.Can you upload the reports? so I can help you better.

Please get back.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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