The nervous system is among the most sensitive organ systems in the body. When trauma or disease strikes the brain and/or spinal cord, the results can be devastating. However, advances in neurocritical medicine have given many people and their families renewed hope of survival and recovery.
During a craniectomy, a portion of the skull is removed, which allows the brain to swell without becoming damaged by hitting the skull. This surgical procedure has revolutionized treatment for traumatic brain injuries, such as gunshot wounds. Previously, if a patient survived the initial trauma, they may still have worsening of their injuries or face mortality from brain swelling. Crainectomies have given neurosurgeons an opportunity to reduce the catastrophic effects of brain swelling and more people are surviving significant head injuries.
Some congenital or acquired conditions cause cerebral spinal fluid to build up inside the ventricles of the brain. This buildup of fluid can cause permanent brain damage. Brain shunts are another medical procedure that has increased survival rates for critical neurological conditions. Shunting is not without risks, such as infection, but the risks associated with infection are often manageable and better than doing nothing.
During the procedure, the neurosurgeon places one end of the catheter inside the brain ventricle, while the other end is implanted inside another area of the body that is able to handle the extra fluid. In most cases, the cerebral spinal fluid is drained into the abdominal cavity and metabolized by the body.
Medically Induced Comas
One treatment option that has become increasingly common in injuries or illnesses that affect the brain is using a medically induced coma. This limits brain functions so the patient can rest and more of their body's energy can be directed toward healing. Medically induced comas have been used with traumatic brain injuries, such as war-related injuries and gunshots, but they have also been used in human victims of rabies.
Although rabies continues to be mostly fatal without prompt treatment, rare instances of survival have been attributed to medical protocols that include medically induced comas. In rabies cases, the medically induced coma may give the immune system more opportunity to fight off the disease, while protecting the brain.
The delicate nature of the brain makes any injury or infection difficult to treat and increases the risk of long-term damage or mortality. However, several advances in neurocritical medicine are increasing the odds of at least partial recovery from injuries and conditions that often left patients in a persistent vegetative state or were fatal. For more information about neurological services and treatment, contact a local neurologist.