Cerebral Hypoxia - Possible Causes, Complications, and Path to Recovery

What Is Cerebral Hypoxia?

It is a condition where the oxygen supply to the brain goes below a certain level for various reasons. This may be due to a reduced blood supply or regular blood supply with reduced oxygen content. Brain cells are highly dependent on an uninterrupted oxygen supply to function normally. And the slightest lowering in oxygen levels upsets them. In about five minutes of oxygen deprivation, they begin to die, and the damage is probably irreversible. More extended periods of hypoxia lead to loss of consciousness, convulsions, brain death, and death of the individual.

What Are the Possible Causes for Cerebral Hypoxia?

Several accidental situations and medical conditions put one at risk of developing cerebral hypoxia. They can be:

1. Drowning.

2. Getting strangled by the neck or suffocation.

3. Choking on something that blocks the airway.

4. Heart attack or poorly functioning heart or lungs incapable of maintaining adequate blood supply to the brain.

5. Extremely low blood pressure.

6. Certain types of seizures.

7. Severe asthma.

8. Head injury.

9. Extensive blood loss due to trauma.

10. Stroke.

11. Poisoning with carbon monoxide gas or inhaling large quantities of smoke.

12. A shock from electrical sources.

13. As a complication of general anesthesia.

14. Drug allergies and overdosage.

15. Traveling to areas with low oxygen levels in the air, such as hill stations.

How Does Cerebral Hypoxia Affect the Brain?

• Once the oxygen supply to the brain is interrupted, the individual loses consciousness in about fifteen minutes. The brain cells start to die in another four minutes and turn nonfunctional.

• When the oxygen supply is wholly cut off from the brain, the condition is called cerebral anoxia. When it is partially interrupted, we call it hypoxia. For individuals who suffered a mild form of hypoxia for a shorter span of time, the chances of recovery are higher. Their period of staying unconscious is relatively short, and recovery is fast without any noticeable long-term consequences.

• Ideally, a person who wakes up from a coma in less than a month seems to have better outcomes at recovery.

• At the same time, chances of recovery are minimal in an individual who stays unconscious for a more extended period due to hypoxia.

• There will be irreparable damage to the brain, which will progress to brain death and death of the individual. Some people tend to stay in a persistent vegetative state without responding to commands or communicating.

What Are the Long-Term Complications of Cerebral Hypoxia?

Depending on the extent of brain injury, those who recover from cerebral hypoxia tend to suffer long-term psychological and neurological complications such as:

1. Occasional spasms and convulsions.

2. Uncontrollable muscle movements and tremors.

3. Short-term or long-term memory loss.

4. Hallucinations.

5. Weakness in hands and legs.

6. Lack of coordination while moving around.

7. Tend to lose balance and fall while walking.

8. Regression of personality adopting childhood mannerisms.

9. Speech and hearing issues.

10. Trouble making decisions, proper judgment, and processing information.

11. Mood swings and depression.

12. Hormone imbalances.

What Are the Signs and Symptoms Indicative of Cerebral Hypoxia?

The following symptoms are detected in an individual affected with mild cerebral hypoxia:

• Inability to focus and lack of coordination in activities and movements.

• Headache and problems with eyesight.

• Light-headed feeling and giddiness.

• Faster breathing and increased sweating.

• Numbness and tingling on body parts.

• Judgment errors.

• Loss of memory and confusion.

If the hypoxia lasts for long in the individual, symptoms, turn severe as in:

• Mental confusion and agitation.

• Turn drowsy and lethargic.

• Shallow breathing or no breathing at all.

• Bluish discoloration of the skin (cyanosis) on lips, mouth, and fingertips indicates low oxygen content in the blood.

• Dilated pupils.

• Uncontrollable jerky movements and convulsions.

• Seizures.

• Loss of consciousness (coma).

How Is Cerebral Hypoxia Medically Managed?

The patient must be admitted to a critical care unit for immediate care. Providing basic life support systems to maintain adequate oxygen levels in the body is the first line of treatment. Place the patient under mechanical ventilation and provide the necessary medications to treat the underlying cause that lead to cerebral hypoxia. If the underlying reason for hypoxia is a heart attack, the doctor will administer cardiopulmonary resuscitation (CPR) and try to revive the patient. Next, monitor and stabilize the patient’s heart rate and blood pressure. This should be accompanied by an adequate supply of fluids, blood transfusion, and nutrients.

The following strategies are also used:

1. Drugs to bring down seizure attacks.

2. Drugs to maintain heart rate and blood pressure.

3. Medically induced coma to protect the brain from further injury.

4. Medically induced cooling of the body (therapeutic hypothermia) to reduce the oxygen needs of the brain. It is found effective in some individuals affected by cerebral hypoxia.

5. The severity of nerve injury is assessed by the Glasgow coma scale (GCS), which is indicative of the level of brain function.

6. An electroencephalogram (EEG) may be conducted to assess the degree of brain damage, which is indicative of the level of brain function and predict seizure attacks. In addition, it helps the doctor to predict the outcome and chances of recovery.

7. Angiography procedure to detect the possible obstruction in the blood flow to the brain.

8. An echocardiography and electrocardiogram (ECG) to detect problems with heart function that might hinder blood supply to the brain.

9. Imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) are used to understand the underlying cause of hypoxia and area of brain damage and to quantify the functional impairment.

10. Somatosensory evoked potentials (SSEPs) - These are a set of electrical stimulation used to send sensations to the brain to evaluate the individual’s reaction and response. This is also useful for predicting the possible outcome after the hypoxic episode.

11. Rehabilitation: To recover from the long-term complications of brain damage, one may require rehabilitation, physical, occupational and speech therapies.

Conclusion:

Care provided in the first few minutes of staying hypoxic is very crucial for higher chances of recovery and for reducing long-lasting complications. The age of the affected individual is a significant determinant for recovery, along with the efforts made for rehabilitation. Remember that immediate hospitalization and providing maximum medical support are vital in bringing about the best possible outcomes in an individual affected by cerebral hypoxia.