Posted on 03/18/2005 10:41:21 PM PST by spycatcher
Terry Wallis' 19-year journey back to consciousness is a remarkable story. But in June 1984, the time of his car crash, he was just another statistic; one more name on the list of 1.5 million Americans who sustain a brain injury each year. Perhaps it's going too far to say that Wallis was one of the fortunate ones, but he did at least survive his brain injury. Each year in America, 50,000 people are not so lucky.
Brain injury is the great silent epidemic. In the US alone there are estimated to be 5.3 million people (more than 2% of the entire population) living with disabilities brought on as a direct result of brain injury. It is the leading cause of death among children and young adults, and it kills 1.5 times more people annually than AIDS.
The UK has its own unnerving statistics. Each year, almost 12,000 people will suffer a head injury so severe that they will remain unconscious for six hours or more. After five years, only 15% of these people will have returned to work. Most head injuries are less severe of course. Of the one million people who visit a UK hospital with head injuries each year, the majority will arrive with only small bumps and knocks.
But even relatively minor head injuries can have serious consequences for the brain. The common symptoms of dizziness, nausea, headaches and memory loss can be complicated by depression, anxiety and mood swings. Most people will make a full recovery after three to four months, but in some cases the changes can be permanent.
The fragile organ
The brain can be damaged in a number of ways: through a stroke, tumour, infection, or a degenerative disease like Alzheimer's, for example. But probably the most common forms of brain injury stem from a physical trauma to the head.
The brain is an extremely delicate organ, with the consistency of firm blancmange. Any sudden jolt causes it to slide around, compressing and expanding as it goes. For the billions of neurons that make up the brain, this is bad news. If the jolt is serious enough, these long fragile nerve cells will be stretched, twisted and sheared.
The extent of internal damage can confound expectations. A gunshot wound to the head, for example, might seem catastrophic, and often is, but when an external object penetrates the skull, the impact is often localised. Contrast this with the kind of serious jolt to the head that might occur in a car crash. Though the skin might remain unbroken, the impact on the brain can be more diffuse, and more devastating as a consequence. The brain will be thrown backwards and forwards against the walls of the skull, causing extensive damage at the points of impact. A bad situation is made worse by the fact that the bones at the front of the skull have a rough, irregular texture that can literally shred the frontal cortex.
The initial impact is often only the start of the brain's problems. With nowhere else to go, blood escaping from burst arteries in the brain will gather in pressurized pools (called haemotomas) and squeeze the life out of neurons. The nerve cells come under further pressure from the swelling that occurs at the site of the injury (known as a cerebral oedema). If the swelling is serious enough, it can kill more neurons by cutting off their supply of blood and oxygen.
The brain bounces back
The brain is extremely sensitive to damage, but it is also surprisingly robust when it comes to recovery. Stroke victims, for instance, often suffer from partial paralysis or speech problems, but they usually regain some or all of their faculties over time. The speed and extent of recovery will depend on the location and extent of the injury, but the chances of improvement are generally much greater for the young than for the old.
A serious brain injury may condemn millions of neurons to death, but amazingly, new neurons may grow in their place. Recent research has shown that regeneration can occur in the hippocampus, a relatively primitive part of the brain that's associated with learning and memory. Elsewhere, the powers of neuron replacement seem restricted. Even so, the brain still has other strategies to overcome the injury.
When neurons die they release toxins that can paralyze neighbouring and otherwise healthy areas of the brain, exacerbating the effects of the initial injury. The job of cleaning up the toxins falls to the glial cells – the neurons' own support network. Once this mopping up operation is complete, millions of neurons are back in business. The disposal of toxic waste together with the rebuilding of damaged blood supplies can do much to aid the brain's initial period of recovery.
Elsewhere, surviving neurons themselves get in on the act, sprouting new lines of contact to help patch up damaged circuits; while the contacts themselves can become more sensitive to compensate for the loss of synaptic inputs. There is also evidence that the brain has circuits which are ordinarily silent but can be switched on in times of crisis.
Concussion and coma
Head injuries are often accompanied by a loss of consciousness. In mild cases, this means concussion lasting a few minutes or seconds. Concussion is caused by temporary neuronal paralysis, but strictly defined, there is no damage to the brain itself.
At the opposite end of the scale, comas are usually measured in terms of hours, days and weeks. They are typically caused by damage to the brain stem, an arousal centre located at the base of the brain. Injury, which can come from a direct hit or from pressure caused by swelling in other parts of the brain, effectively shuts down consciousness. Since the brain stem is a central hub for neuronal circuits, damage to this area can also have drastic knock-on effects that extend throughout the brain.
Comas are poorly understood and difficult to define. But in general, someone with their eyes closed all the time, who is unable to communicate or respond to instructions, is in a coma. Whether comatose people really are oblivious to the outside world is a moot point. People who have recovered from comas claim they had at least some awareness of their surroundings; they were just unable to demonstrate it. One apocryphal story even tells of a comatose Terry Wallis shaking his head when his family were presented with a massive doctor's bill.
Officially, the end of a coma is signalled by the opening of the eyes. Although it is a good sign that some functionality is returning to the arousal centre of the brain, people can remain trapped in so-called 'vegetative states' for months or even years after they open their eyes for the first time. In truth, people do not suddenly 'wake-up' from a coma; they make a slow and sometimes painful return to consciousness, via incremental improvements to their sense of themselves and their environment.
Healing power
When doctors first got a look at Terry Wallis after his car crash all those years ago, they knew that his prospects were not good. With extensive damage to his temporal lobe, frontal cortex and brain stem, the prognosis looked bleak. Days turned into weeks; weeks into months; months into years. The longer it went on, the worse his odds became. But his mother, Angilee, stuck by him on his 19-year journey back to consciousness, and his story became a real victory for the family who never gave up hope.
The doctors were right, of course: Wallis had all the symptoms of a lost cause. But the brain remains the most enigmatic of organs, tender yet tenacious, vulnerable but strong. It may be fragile, but it is nothing if not resourceful. Even in the most hopeless cases, it can still bounce back and surprise us.
But the brain doesn't get better just on its own. Like a muscle, it requires mental exercise to regain some of its strength. Specialised therapies are vital to the treatment of people recovering from brain injury. Even in older people, the brain retains a certain degree of plasticity, and faculties lost can sometimes be regained through the training and reworking of the brain pathways that remain. Angilee's routine visits to Terry's bedside may have been made more in hope than expectation, but who knows what essential nourishment her gentle but regular inputs provided?
Of course, Terry is not out of the woods yet. His awareness of himself and his surroundings are still distorted, and he seems to lack a short-term memory. Perhaps these faculties will never be regained. But if the Terry Wallis story teaches us anything, it is never say never.
***In the US alone there are estimated to be 5.3 million people (more than 2% of the entire population) living with disabilities brought on as a direct result of brain injury. It is the leading cause of death among children and young adults, and it kills 1.5 times more people annually than AIDS.***
And the leading cause for voting Democrat.
Just think, if a President Hillary nominates Judge Greer to the Supremem Court in a few years we can kill 2% of the population and save Social Security and Medicare!
***Just think, if a President Hillary nominates Judge Greer to the Supremem Court in a few years we can kill 2% of the population and save Social Security and Medicare!
***
brilliant! but im pretty sure more than 2% of the population is Republican...
oh wait, 2% is braindead? Still, more than 2% of the population is liberal...
Conversely the effects of sandbagging (as you put it). Bookmark this.
At last, an expose of John Kerry's senate career.
"The Man Who Slept for 19 Years"
At last, an expose of John Kerry's senate career.
You are too funny!
How about the man who drank for sixty years....Ted Kennedy?
And hired on a chauffeur 30 years ago on our tab!
At last, an expose of John Kerry's senate career.
Ah yes, I remember him! The one who broke Senate rules and refused to pay back almost $200,000 in absence via his unearned wages.
Thankfully this merciful act may have prevented yet more young girls from drowning.
L.O.L....but crying
Sadly enough it prevented his own at the same time....
Yea, me too.
Great!!
However it's the dreams he had during those 19 years that are scary.
Save.
I had an aunt that couldn't speak a word or eat. She also walked with a limp(draged her foot). By the time she died, you could understand most things she said and she fed herself and the limp was barely noticeable. It took several years though.
Rip Van Winkle?
The problem of brain injury/damage, is FAR more extensive than this article reports.
They've overlooked the 49% of the adult population that voted for Kerry....
Article is clearly another example of MSM bias.
Semper Fi
And how long has Ms. Schindler (Terry Schiavo) been brain damaged? Why doesn't Barb Boxer just walk in with a box cutter and get it over with? Sheez, we wouldn't want to wait 19 years... human life aint worth it!
sarcasm/off
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