Emergency Surgery for Traumatic Brain Injury After Car Accident - Neurosurgery

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Emergency surgery for retroperitoneal hemorrhage due to a car accident?


My son was in a car accident last Friday around 11 PM.
He underwent emergency surgery due to his critical condition and is currently in the intensive care unit, in a coma for 4-5 days.
He is very restless and has only four movements; he hasn't regained consciousness yet.
The doctor said it is very dangerous and could lead to infections.
I don't know how to handle this.
Dr.
Ding, is my son in a critical condition?

Wang, 50~59 year old female. Ask Date: 2015/09/16

Dr. Ding Xianwei reply Neurosurgery


It is very dangerous! Moreover, there is no guarantee that one will regain consciousness.
According to research, if the coma scale is five or below (including five), the mortality rate is significantly higher compared to a score above five.
However, I do not understand the part regarding the virus.

Reply Date: 2015/09/16

More Info


I'm sorry to hear about your son's situation following his car accident. Traumatic brain injuries (TBIs) can be incredibly serious, and the need for emergency surgery indicates that there was significant damage that required immediate intervention.
In cases of TBI, the brain can suffer from various types of injuries, including contusions (bruising), lacerations (tears), and hemorrhages (bleeding). The fact that your son is currently in the intensive care unit (ICU) and has been in a state of coma for several days suggests that he is in a critical condition. The Glasgow Coma Scale (GCS) is often used to assess a patient's level of consciousness after a brain injury, and a lower score indicates a more severe injury.
The medical team will be closely monitoring your son's vital signs, intracranial pressure, and neurological status. The risk of complications, including infections, is heightened in patients with severe TBIs, especially if they have undergone surgery. Infections can arise from various sources, including surgical wounds, ventilator-associated pneumonia, or urinary tract infections, particularly if he is intubated or has a catheter in place.

Here are some key points to consider regarding your son's condition and the management of TBIs:
1. Monitoring and Support: Continuous monitoring in the ICU is crucial. Medical staff will assess his neurological status regularly and may perform imaging studies to evaluate any changes in his condition. Supportive care, including maintaining adequate oxygenation and blood pressure, is vital.

2. Potential for Recovery: While it is difficult to predict the outcome for patients with severe TBIs, some do recover significant function over time. Factors influencing recovery include the severity of the injury, the patient's age, and the speed of medical intervention.
3. Communication with Healthcare Providers: It is essential to maintain open lines of communication with your son's medical team. They can provide updates on his condition, explain the interventions being performed, and discuss potential outcomes. Don't hesitate to ask questions or express your concerns.

4. Family Support: The emotional toll on families during such crises can be overwhelming. It is important to take care of your own well-being and seek support from friends, family, or counseling services if needed.
5. Rehabilitation: If your son begins to show signs of recovery, rehabilitation will be an important part of his recovery process. This may include physical therapy, occupational therapy, and speech therapy, depending on the nature of his injuries.

6. Infection Prevention: The medical team will implement protocols to minimize the risk of infection, including maintaining sterile techniques during procedures and monitoring for signs of infection.

In conclusion, while your son's situation is indeed serious, it is important to remain hopeful and engaged with his care team. They are best equipped to provide the necessary interventions and support. Remember that recovery from a traumatic brain injury can be a long and complex process, and each patient's journey is unique. Your involvement and support can play a significant role in his recovery.

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