Recovery timeline for brain trauma question

gismo

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The 20 year old daughter of a good friend was in a serious accident 13 days ago while attending school in Spain and has been in a medically induced coma until recently. The doctors have backed off on the sedation and she's slowly coming around but the operative word is "slowly". Over the last two or three days she's gone from catatonic to squeezing hands, opening eyes, and smiling on one occasion.

The accident involve literally getting hit by a bus (a big one) going an estimated 30 mph at the time of impact. She has broken ribs and a broken pelvis (surgically repaired a couple days ago), numerous contusions but the biggest concern is that her head made a significant dent in the bus's windshield. At first the doctors were concerned about cranial swelling but apparently that's not a problem now and AFaIK her skull was not fractured. She has exhibited movement in all her limbs so it would appear that there's no spinal injury (yea!).

I'm wondering if the painfully slow return to "normal" alertness is typical of this kind of recovery or if it's an indication of "brain damage" and what should be expected in the future.
 
I am no doctor, but from experience I can tell you it is a long row to hoe. Having said that, I have seen remarkable recoveries from worse injuries. I think most DR's would say "Its too soon to tell" about a full recovery. At least she is alive, and has a chance.
 
Recovery is very variable, but it'll probably be a long way back.

Getting her to a good rehab hospital stateside should be a priority. They do miracles. I hope she had some sort of repatriation insurance.
 
If there truly was no intracranial swelling, the prognosis for recovery of mental function is pretty good. The brain is interestingly adept at rewriting around damaged portions, but if the damaged portions were critical and damage extensive, the loss of them is problematic.

At this stage the brain may just be slow in waking up because of all the other damage so is doing the same thing naturally that the docs were doing chemically.

Just wish for the best is about all we can do at this juncture, recovery from head wounds is highly variable.
 
I realize henning knows the unknown soldiers mother but in this case I would rely on medical experts rather than this site.
 
I realize henning knows the unknown soldiers mother but in this case I would rely on medical experts rather than this site.

I don't think anyone is giving medical advice, just responding to what the potentials are. At this point I'd bet the doctors are saying "We'll have to wait and see." which is all that can be done now anyway.
 
The 20 year old daughter of a good friend was in a serious accident 13 days ago while attending school in Spain and has been in a medically induced coma until recently. The doctors have backed off on the sedation and she's slowly coming around but the operative word is "slowly". Over the last two or three days she's gone from catatonic to squeezing hands, opening eyes, and smiling on one occasion.

The accident involve literally getting hit by a bus (a big one) going an estimated 30 mph at the time of impact. She has broken ribs and a broken pelvis (surgically repaired a couple days ago), numerous contusions but the biggest concern is that her head made a significant dent in the bus's windshield. At first the doctors were concerned about cranial swelling but apparently that's not a problem now and AFaIK her skull was not fractured. She has exhibited movement in all her limbs so it would appear that there's no spinal injury (yea!).

I'm wondering if the painfully slow return to "normal" alertness is typical of this kind of recovery or if it's an indication of "brain damage" and what should be expected in the future.

As another said.. its variable...

Recovery to baseline is not guaranteed. When I worked as an ICU nurse in neurotrauma ICU, I would tell my patient families it is "when it happens, if it happens, on its own schedule".

The scary part may be over, but the hard part is possibly just beginning. Lots of patience will be required.
 
I realize henning knows the unknown soldiers mother but in this case I would rely on medical experts rather than this site.
There are several medical experts on this site. They chime in from time to time. We recognize that we aren't there, viewing the patient and the chart and the diagnostics. Some things are pretty universal though. The variability and unpredictability of recovery from a traumatic brain injury is one of them.
 
All the more reason for medical experts on scene to be relied on. I'm sure they are aware of any problem discussed here with the decided advantage that they are THERE!
 
All the more reason for medical experts on scene to be relied on. I'm sure they are aware of any problem discussed here with the decided advantage that they are THERE!
This is one where it doesn't matter that the medical professionals are not there. The answer is as already stated 'it varies.'
Sucks, hope it all works out well and quick as possible.
 
All the more reason for medical experts on scene to be relied on. I'm sure they are aware of any problem discussed here with the decided advantage that they are THERE!

The doctors can't answer the question any better, head trauma is 'wait and see' game. I may not be a doctor, but my life has exposed me to a lot of traumatic injuries both mine and friends, and I have friends (and my dad) who have had varying levels of recovery. There also comes in the future risk of strokes from blood clots that may form during the healing (happened to my dad last year from his fall on the ice two years prior). There are just so many variables nobody can say anything definitive except "hope for the best".
 
All the more reason for medical experts on scene to be relied on. I'm sure they are aware of any problem discussed here with the decided advantage that they are THERE!

Your opinion is noted. You are free to do what you please. However, A general question was asked by someone else, and a general answer was given to someone else.

Lets try not to let your personal feelings get in the way of someone elses learning.

Perhaps now the OP is better prepared to ask better questions of the medical team. I know that I appreciate informed educated patients and families, it gives a good foundation to build upon when providing patient education.
 
Lance,

My best friend was involved in a car accident about 15 years ago that sounds somewhat similar - Head mostly through the windshield and a bunch of the other details sound very similar. He was in the hospital for 6 weeks and full-time daily rehab for 6 months.

He began coming out of the coma a few days after the accident and they had to sedate him again - It was as if his brain was still in the accident and panicked, and he began thrashing around and hurting himself again. They kept him in a medically induced coma for two weeks.

After he woke up, I got a phone call from him thanks to his wife - And it was pretty scary. He sounded delirious, and was saying things that made no sense. He kept talking about upstairs phone lines and downstairs phone lines and such... I actually started taking notes because it really made no sense in the moment at all and I wanted to look at it and try to process it later. Afterwards, I called my mother, a former ER nurse. To her, it all made sense - He was trying to tell me that the "upstairs phone lines" (his brain) weren't connected properly to the "downstairs phone lines" (his body/mouth). He knew he wasn't making sense, but he still couldn't make sense!

He also had some pretty bad amnesia at first. Not only did he not remember things before the accident, he couldn't remember things day to day either for the first couple of weeks in the hospital, though he did seem to know who we was talking to when we first spoke.

There were some humorous moments. He had gotten married a few months prior to the accident. When he first woke up and they let his wife come visit, she came in and he had no idea who she was (the docs had prepared her for this). She told him she was his wife and that they'd been married for a few months, and he responded "Hmmm. That's interesting. I don't find you at all attractive." :rofl:

There were also some sad moments. His mother had died not long before the accident, and for those couple of weeks, every time he asked to talk to her, they'd have to tell him, again, that she was dead. :(

Eventually, he began to remember his wife when she came for her daily visit, and happily exclaim "Baby!" when he saw her at his door. And eventually, when he thought about his mom one day while his wife was there, he said "She's not here any more, is she?"

About 2 months after the accident, not long after he got out of the hospital, I flew down to see him. He still had a lot of trouble cognitively. We cooked some brats on the grill and he didn't seem to be able to put together what steps were required to do so, but we did it and I think that helped.

And for the last bit of bad news - Nobody is ever the same. Nobody makes it back to 100% after a traumatic brain injury.

BUT... Here's the good news. They can get very close - Close enough that you wouldn't know the difference. The only people who would know the difference between my friend before the accident and my friend now would be people who knew him REALLY well both before and after. I'd guess that outside of me, his then-wife, and his dad, nobody would know the difference now had they not known about the accident and not talked to him in the first year or two afterwards.

The main lasting effect after that first couple of years was that he could no longer remember things he has to do or appointments he has to keep. So, he simply compensates by carrying a little black book to take notes in now, same as many people have to do without any brain injury!

And the kicker is his occupation. He's now a full-time elected politician. :rofl:

So, the quick and dirty is that it'll be very hard for your friend at first, because things will likely seem very bad at first, and it'll take a long time for her to recover, relatively speaking - The bones will heal before the brain. But the brain is an amazing organ, and chances are she'll be just fine eventually.

Good luck!
 
Your opinion is noted. You are free to do what you please. However, A general question was asked by someone else, and a general answer was given to someone else.

Lets try not to let your personal feelings get in the way of someone elses learning.

Perhaps now the OP is better prepared to ask better questions of the medical team. I know that I appreciate informed educated patients and families, it gives a good foundation to build upon when providing patient education.

I certainly am free to choose my hospital. Years ago I sailed with the head of thorasic surgery at pres. Hosp. NYC. His words, not mine. " if your ever really Ill, a major event, be sure your at a teaching hospital where, if something goes south, you have a lot of talent that can be called in to help you. " this seemed to me a major event. Here in Baltimore we have univ. Of maryland and Johns Hopkins. Two excellent hospitals so I feel fortunate. ( verses getting advice from the internet.)
 
I certainly am free to choose my hospital. Years ago I sailed with the head of thorasic surgery at pres. Hosp. NYC. His words, not mine. " if your ever really Ill, a major event, be sure your at a teaching hospital where, if something goes south, you have a lot of talent that can be called in to help you. " this seemed to me a major event. Here in Baltimore we have univ. Of maryland and Johns Hopkins. Two excellent hospitals so I feel fortunate. ( verses getting advice from the internet.)

You clearly win then :yes: .
 
I certainly am free to choose my hospital. Years ago I sailed with the head of thorasic surgery at pres. Hosp. NYC. His words, not mine. " if your ever really Ill, a major event, be sure your at a teaching hospital where, if something goes south, you have a lot of talent that can be called in to help you. " this seemed to me a major event. Here in Baltimore we have univ. Of maryland and Johns Hopkins. Two excellent hospitals so I feel fortunate. ( verses getting advice from the internet.)
Cool. Do you have a traveling trauma team following you when you fly?
 
Lance,

My best friend was involved in a car accident about 15 years ago that sounds somewhat similar - Head mostly through the windshield and a bunch of the other details sound very similar. He was in the hospital for 6 weeks and full-time daily rehab for 6 months.

He began coming out of the coma a few days after the accident and they had to sedate him again - It was as if his brain was still in the accident and panicked, and he began thrashing around and hurting himself again. They kept him in a medically induced coma for two weeks.

After he woke up, I got a phone call from him thanks to his wife - And it was pretty scary. He sounded delirious, and was saying things that made no sense. He kept talking about upstairs phone lines and downstairs phone lines and such... I actually started taking notes because it really made no sense in the moment at all and I wanted to look at it and try to process it later. Afterwards, I called my mother, a former ER nurse. To her, it all made sense - He was trying to tell me that the "upstairs phone lines" (his brain) weren't connected properly to the "downstairs phone lines" (his body/mouth). He knew he wasn't making sense, but he still couldn't make sense!

He also had some pretty bad amnesia at first. Not only did he not remember things before the accident, he couldn't remember things day to day either for the first couple of weeks in the hospital, though he did seem to know who we was talking to when we first spoke.

There were some humorous moments. He had gotten married a few months prior to the accident. When he first woke up and they let his wife come visit, she came in and he had no idea who she was (the docs had prepared her for this). She told him she was his wife and that they'd been married for a few months, and he responded "Hmmm. That's interesting. I don't find you at all attractive." :rofl:

There were also some sad moments. His mother had died not long before the accident, and for those couple of weeks, every time he asked to talk to her, they'd have to tell him, again, that she was dead. :(

Eventually, he began to remember his wife when she came for her daily visit, and happily exclaim "Baby!" when he saw her at his door. And eventually, when he thought about his mom one day while his wife was there, he said "She's not here any more, is she?"

About 2 months after the accident, not long after he got out of the hospital, I flew down to see him. He still had a lot of trouble cognitively. We cooked some brats on the grill and he didn't seem to be able to put together what steps were required to do so, but we did it and I think that helped.

And for the last bit of bad news - Nobody is ever the same. Nobody makes it back to 100% after a traumatic brain injury.

BUT... Here's the good news. They can get very close - Close enough that you wouldn't know the difference. The only people who would know the difference between my friend before the accident and my friend now would be people who knew him REALLY well both before and after. I'd guess that outside of me, his then-wife, and his dad, nobody would know the difference now had they not known about the accident and not talked to him in the first year or two afterwards.

The main lasting effect after that first couple of years was that he could no longer remember things he has to do or appointments he has to keep. So, he simply compensates by carrying a little black book to take notes in now, same as many people have to do without any brain injury!

And the kicker is his occupation. He's now a full-time elected politician. :rofl:

So, the quick and dirty is that it'll be very hard for your friend at first, because things will likely seem very bad at first, and it'll take a long time for her to recover, relatively speaking - The bones will heal before the brain. But the brain is an amazing organ, and chances are she'll be just fine eventually.

Good luck!
Thanks Kent, this is the kind of info I was looking for.
 
I certainly am free to choose my hospital. Years ago I sailed with the head of thorasic surgery at pres. Hosp. NYC. His words, not mine. " if your ever really Ill, a major event, be sure your at a teaching hospital where, if something goes south, you have a lot of talent that can be called in to help you. " this seemed to me a major event. Here in Baltimore we have univ. Of maryland and Johns Hopkins. Two excellent hospitals so I feel fortunate. ( verses getting advice from the internet.)

If I ever relocate, the R Adams Cowley Shock Trauma hospital at UMBC downtown is on my short list of dream jobs.. Great place. You are fortunate to live in the area, Trauma care wise.
 
When I crashed my plane and was at the trauma center in Atlanta, the new head of surgery there had just come down there from Shock Trauma where she had done her training. When she saw where my home was in Maryland she wore her old Shock Trauma lab coat out when she first met my wife. It made her feel a lot better about my care., knowing she had the best team working on me. Shock Trauma has had a tremendous effect on care across the country with its training.
 
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