Head Injuries 8, Raised intracranial pressure

[@andreaacker739]

My daughter had a near-SIDS event one month after discharge from NICU, gest 28 wks. This lead to hypoxic ischemic brain injury. The result was diffuse brain damage concentrated in the occipitals and diffusing toward the parietals and temporals, completely absent in the frontals. Interestingly, her deficits began with swallowing problems then speech apraxia as she has aged, poor proprioception, fine and gross motor deficits, and mild/moderate learning disabilities. I've been on a quest for 11 years now to determine the pathophys of this type of injury and why her deficits do not match up to the MRIs which is surprisingly difficult to do. Lots of info on strokes and TBI, not much on hypoxia. I'd like to recap what I think happened in the acute phase, please correct me if I am wrong if you have the time. The lack of oxygen is detected by the chemoreceptors, RR and HR increase. As the brain loses it's source of oxygen, the blood vessels respond with vasodilation and cytotoxic cellular swelling. CSF is also retained as the brain attempts to compensate and "look" for more oxygen. This causes cerebral edema. The cellular swelling causes sodium to be retained and potassium to be leaked, eventually rupturing the cell causing cell death. Throughout the body, cells are relying on anaerobic sources of energy and releasing lactic acid causing metabolic acidosis and eventually hyperkalemia. Both cerebral edema and hyperkalemia cause heart dysrhythmias and eventual v-fib. Clinically, she had the following: hyperkalemia, hyponatremia, bradycardia, bradypnea, metabolic acidosis, ammonuria and oliguria. Here's where things get confusing to me. I don't really think it was as "simple" as a near-SIDS event. She was just over 5 lbs and had immunizations 3 days prior. No, I'm not going anti-vax on you. She already had mild feeding problems and the bottle was a lot of work for her. I think the vaccines caused the normal reactions of fatigue and maybe some muscle soreness. She got "lazy" with her bottle and wasn't taking in what she should have even though I was still waking her every 3 hours for feedings. I didn't understand how critical the intake volume was with each and every feeding. That lead to hypovolemic shock and subsequent hypoxia. I have put this all together throughout the years but your videos summed it up quite nicely for me and validated my thoughts. There is, however, one piece of the puzzle I am still searching for and haven't found any answers to. Why hasn't she had difficulty with interpreting visual information? It also appears that her primary motor cortex and possibly premotor cotex suffered the most and there was hardly any brain damage visible on the MRI in that area. Let me know if you have any ideas or if you can direct me to another youtuber with more information. Thank you for sharing your knowledge.

[@sowmyavasanth7998]

well..what to say..u r just awesome teacher

[@geojor]

thank you...

[@skynguyen3342]

Thank you Dr.

[@x10secsx]

What specifically causes bradycardia and abnormal respirations? Is it due to the medulla attempting to reduce ICP? How does it work?

[@Campbellteaching]

+x10secsx The respiratory and cardiovascular centers are located in the brain stem, mostly in the medulla oblongata. If the pressure increases in the infratentorial compartment, these centres increase perfusin pressures to try and maintain their own blood supply. These effects will not lower ICP.

[@x10secsx]

+Dr. John Campbell thankyou!

[@faisalbi1330]

Hi Dr please please I want to contact u please email addres please

[@MsMusicObsessed]

Thank you :)

[@ebrahembenbadis590]

Neuro videos pleas tumors,epilepsia,coma, thanks #algeria