Why Are Brain Injury Patients Put Into Medically-Induced Comas?
When Michael Schumacher recently suffered a severe brain injury while skiing, he arrived at the French hospital already in a coma. Schumacher is likely to remain in the coma for at least a few more days, and possibly much longer. Doctors are also keeping his body temperature near hypothermia levels.
It might seem strange at first glance. Why would doctors put an injured man into near hypothermia and keeping him in a medically-induced coma? The answer is simple; these are two of the best forms of treatment we have for severe traumatic brain injuries at the moment.
When the brain is injured it tends to swell. But, unlike most parts of your body, it doesn’t have anywhere to go. The inflammation can cause the brain to push up against the skull and increase pressure. Too much pressure and critical functions such as blood supply can be cut off.
“You’re worried because the skull is a closed space,” Dr. Nicholas Schiff, professor of neurology and neuroscience at Weill Cornell Medical College, told CNN. “As the brain starts to expand, the only place it has to go is down and out, and you damage the brain stem. You can die. You can create a lot of tissue damage.”
Putting patients into medically-induced comas and keeping them at cold temperatures allows the brain to rest and not exert itself more than absolutely necessary. Too much activity would speed up brain damage.
“It’s kind of like cooling the engine down and allowing the healing process to, sort of, slowly occur,” director of emergency neurosciences in the Department of Emergency Medicine at the Emory University School of Medicine, Dr. David Wright said. “It also decreases the swelling of the brain, hopefully, and reduces the chance that you’re going to get that increased intracranial pressure that’s occurring.”
“The goal in management is to really try to reduce and slow any of those processes down so you can save as many of the brain cells as possible,” Wright explained.
Schumacher’s body temperature is being kept between 34 and 34 degrees Celsius (93.2 and 95 degrees Farenheit), and he is being given anesthetics. Any colder and the temperature could become harmful, however the treatment is usually effective for decreasing intracranial pressure.