Our lawyers handle anoxic brain injury lawsuits. An anoxic brain injury can be caused by a mistake by the obstetrician during childbirth or from a traumatic accident. Our law firm has handled enough of these cases where we understand the science of what happens. Below are answers to a lot of questions people often ask who have or love someone who is suffering from an anoxic brain injury.
What Is an Anoxic Brain Injury?
The human brain is the body’s most incredible and complex organ. The brain is made up of more than 100 billion nerves that are connected and communicate with each other through trillions of connections called axons.
Although the brain makes up only about two percent of a person’s body weight, it uses about 20 percent of the body’s energy and oxygen. The brain is not only responsible for conscious functions like rational thought, planning, and speaking, but is also responsible for unconscious processes like heart rate, body temperature, and sleep cycles.
Like all cells in the body, brain cells produce energy through a process called cellular respiration. Cellular respiration is a process where glucose, amino acids, and fatty acids are metabolized with oxygen to produce adenosine triphosphate, which is used to power the cellular mechanisms of the brain. Without oxygen, the brain cannot metabolize glucose and is starved of energy very quickly.
Anoxia is the term to describe an absence or deficiency of oxygen reaching the tissues and organs of the body. When the brain suffers oxygen deprivation it can lead to an anoxic brain injury, also referred to as cerebral hypoxia or a hypoxic-anoxic injury, commonly referred to as HAI. An anoxic injury is the result of a complete lack of oxygen while a hypoxic brain injury is the result of a partial lack or inadequate supply of oxygen. An anoxic brain injury can have varying results depending on the length of time of the oxygen deprivation. Symptoms include cognitive problems and mental disabilities, but the ultimate consequence is brain death. Cerebral anoxia may also produce brain swelling, and this can add to the damage, by squeezing off smaller blood vessels and interrupting the local blood supply.
The most vulnerable areas of the brain regarding hypoxic injury include the neocortex, hippocampus, basal ganglia, cerebellar A severe anoxic brain injury may damage the hypothalamus and pituitary gland, small structures at the base of the brain responsible for regulating the body’s hormones. Damage to these areas can lead to an insufficient or increased release of hormones, which can disrupt the body’s ability to maintain a stable internal environment or homeostasis.
How Long Can You Go Without Oxygen to the Brain?
Luckily for the brain, it can endure up to several minutes without oxygen, so when a toddler holds their breath or a swimmer spends a period under water, there are no adverse effects on the brain.
The damage to the brain during lack of oxygen depends on many factors including age, preexisting conditions like cardiac and lung function, previous strokes or heart attacks, and diabetes.
But if oxygen is depleted from the brain for longer than four minutes, brain cells start dying. After five minutes, a permanent anoxic brain injury can occur.
How Long Does It Take Brain Cells and Brain Damage to Occur Without Oxygen?
The long-term cognitive results of an anoxic or hypoxic event are caused by brain cell death. During anoxic conditions between 30 seconds and three minutes, the sufferer will lose consciousness. Brain cells begin dying after 60 seconds. At the three-minute mark, the brain’s neurons suffer extensive damage, and lasting brain damage becomes very likely.
After five minutes there is a high probability of death. After ten minutes, if the victim is still alive, a coma and permanent brain damage are inevitable. After 15 minutes the victim suffers certain death.
Let’s look at this same issue from the perspective of just how much oxygen you can lose. Because often it is not all or nothing. At about 75% of normal blood oxygen levels, complex task performance is impaired. When you go to 65% oxygen, memory is impaired.
As deprivation increases, the brain heads south. At 50% oxygen, judgment is impaired and unconsciousness may occur. If a patient is at 30-40% oxygenation, death is likely imminent.
What Are the Types of Anoxic Brain Injuries?
The medical field generally classifies anoxic brain injuries into four categories. The categories give insight into the long-term prognosis of an anoxic brain injury.
The first level of injury is diffuse cerebral hypoxia, which is mild to moderate damage resulting from low blood oxygen levels that cause minimal brain impairment.
The next level of injury is focal cerebral ischemia, which is caused by oxygen deprivation most commonly as the result of a stroke. This type of injury is usually limited to a single area of the brain, while other areas of the brain are left unaffected.
Global cerebral ischemia is the complete cessation of blood flow and oxygen to the brain that causes catastrophic harm.
Finally, cerebral infarction is a brain injury due to a stroke that completely deprives multiple brain regions of oxygen leading to severe effects and eventual death.
How Do You Get an Anoxic Brain Injury?
Generally, anoxic brain injuries are classified into five groups.
Anemic anoxia occurs when the blood cannot carry sufficient oxygen to the brain. Some conditions including lung disease can lead to insufficiently oxygenated blood. This type of injury can occur even if there is adequate blood flow, but the blood is inadequately oxygenated, so the brain will not be able to perform vital functions. The brain can compensate for lowered oxygen levels by increasing blood flow by double, but if there is still inadequate oxygen a hypoxic brain injury is still possible.
Toxic anoxia is a form of anoxia that is caused by toxins that prevent the blood’s oxygen from being used efficiently. Carbon monoxide poisoning is a common form of toxic anoxia. Another common type of toxic anoxia occurs as the result of medical malpractice when anesthesia is improperly administered during surgery.
Stagnant anoxia, also known as a hypoxic-ischemic injury or HII, occurs when an internal condition blocks sufficient oxygen-rich blood from reaching the brain. Strokes, cardiac arrhythmia, and cardiac arrest can all cause HII.
Anoxic anoxia is a condition that is caused when there is not enough oxygen in the air for the body to benefit from it. This condition can occur at high altitudes where less oxygen is available in the air.
Hypoxic ischemic encephalopathy also referred to as HIE, is a type of brain injury that occurs during birth. This type of brain injury an extremely dangerous condition that requires immediate medical attention.
Children that suffer HEI injuries at birth have a higher risk for permanent neurological problems, including developmental delays, gross and fine motor deficiencies, hypertonicity, seizures, visual impairment, cognitive dysfunction, and spasticity.
Is an Anoxic Brain Injury a Traumatic Brain Injury?
Traumatic brain injuries happen as the result of direct physical trauma caused by some external force on the brain like a car collision, explosion, sports-related injury or a gunshot wound. Unlike traumatic brain injuries, anoxic and hypoxic brain injuries are the result of a lack of oxygen delivered to the brain via the bloodstream. Although traumatic brain injuries and anoxic brain injuries are different types of injuries they can have symptoms in common, like dizziness, loss of consciousness, and in the long term, memory problems and personality changes.
Why Are Some Anoxic Brain Injuries Delayed?
Brain cell death may be the result anywhere between minutes to weeks. So the long-term cognitive effects of an anoxic event are not always noticeable immediately afterward. This is science that is hard for jurors to get their mind around in many brain injury accident cases. The victim looks fine to the naked eye. But what we know is anoxic injuries often cause delayed problems with short-term memory, executive function, and emotional control. Good medical experts are critical at trial to explain why some injuries – typically brain cell death in the hippocampus – take so long to manifest.
Is an Anoxic Brain Injury a Stroke?
An anoxic brain injury and a stroke are two separate but related events. An anoxic brain injury is not a stroke, but a stroke often leads to an anoxic or hypoxic brain injury.
An ischemic stroke occurs when a blocked artery deprives the blood supply to part of the brain. A hemorrhagic stroke is the result of the leaking or bursting of a blood vessel. During a stroke, brain cells begin to die within minutes due to the lack of oxygen being delivered to the brain.
Can the Human Brain Heal Itself?
The severity of brain damage due to an anoxic event is dependent on the extent of the oxygen deprivation. Some people recover from an anoxic brain injury with little or no consequences, while others suffer more severe injuries that need years of therapy for rehabilitation.
The brain is a complex organ with an incredible ability to heal itself. This capability referred to as plasticity, is the capacity of the nervous system, especially the brain, to modify and change.
There are three ways in which the brain can heal itself including collateral sprouting, substitution of function, and neurogenesis. Collateral sprouting happens when the brain grows new axons – the long threadlike part of a nerve cell from which impulses are conducted from the cell body to other cells – to compensate for adjacent damaged and non-functioning neurons. Substitution of function occurs when the role of an injured area of the brain is taken over by another area of the brain. Neurogenesis happens when the brain generates new neurons. Although neuroscientists widely believed that the brain already contains all the potential neurons at birth, studies have found that monkeys have shown new neuron growth, leading researches to believe that humans are also capable of new neuron growth.
Although the brain does have the ability to repair itself following a traumatic or anoxic brain injury, scientists and doctors are working on cutting-edge technology that allows for artificially correcting injuries in the brain. A procedure currently utilized by doctors is a brain graph where brain tissues, especially those coming from fetuses, are implanted in damaged areas of the brain allowing neurons to grow new connections with neighboring neurons. The procedure has had some success for stroke victims, and Alzheimer’s and Parkinson’s disease patients.
What Are the Causes of Lack of Oxygen to the Brain?
There are many causes for lack of oxygen to the brain including those that are the result of external forces including strangulation, choking, whether by food or some other object, or by a lack of airflow from a broken or collapsed trachea.
Drowning, electrocution, poisoning, smoke or carbon monoxide inhalation and poisoning, including via overdose of prescription and illicit drugs or alcohol, are also conditions that can lead to an anoxic brain injury.
Some internal causes of anoxia include heart arrhythmias or irregular heartbeat, brain tumors that impede blood flow, and extremely low blood pressure, which frequently occurs when the body goes into shock due to other injuries.
What Are the Symptoms of Lack of Oxygen to the Brain?
The nerve cells of the brain have a high demand for energy and are particularly sensitive to lack of oxygen. Anoxia may produce damage to the cerebral cortex, the hippocampus, which is responsible for memory, the basal ganglia and the cerebellum, both of which contribute to the control of movement and are particularly sensitive to anoxia.
Effects of oxygen deprivation and other brain injuries can be difficult to distinguish. Symptoms may last for just a few minutes or can become permanent depending on the severity of the deprivation and the length of time before oxygen restoration. As the degree of anoxia becomes more pronounced, confusion, agitation or drowsiness may become apparent. If the anoxia is severe, it will result in loss of consciousness and coma.
A person suffering oxygen deprivation often include changes in heart rate and decreased circulation in the hands or feet. Lack of oxygen can also lead to cyanosis – a bluish tinge to the skin, often most apparent around the lips, mouth, and fingertips. Fainting, seeing spots, or being unable to think clearly are also common symptoms.
As anoxia becomes more pronounced, sufferers have decreased judgment or awareness often accompanied by slurred or garbled speech and the inability to follow directions or complete complex tasks. Some sufferers may experience a headache, hearing loss, muscle weakness or nausea and vomiting. There may also be myoclonus – brief jerking of the limbs – and seizures, bladder or bowel control problems, difficulty swallowing or walking.
Long-term the consequences of anoxic brain injury can include personality and behavioral disturbances, impulsiveness, lack of empathy, distractibility, lack of inhibition, childlike behavior and irritability.
What Foods Heal the Brain?
Although food by itself has not been shown to cure brain damage resulting from anoxic brain damage, some foods and a nutritious diet may enhance healing and support medical treatment of anoxic brain injuries. Vitamin E, found in nuts, seeds, and vegetable oils is a potent antioxidant that supports the body’s ability to resist infection and heal from infections and disease. Fruits and vegetables are excellent sources of antioxidants, including vitamin C, beta-carotene, and lycopene. Antioxidants are known to help rid the body of substances known as free radicals, which cause deterioration in the brain. Antioxidants can also help reverse memory loss and restore balance and coordination.
Blueberries have been shown help protect the brain from oxidative stress and may reduce the effects of age-related conditions such as Alzheimer’s disease or dementia. Avocados have also been shown to promote brain health. Although the avocado is a fatty fruit, its fat is monounsaturated fat, which contributes to healthy blood flow.
Whole grains contain all nutritious parts of the grain and can provide more antioxidants, fiber, and protein compared to refined grains. Examples of whole grain products include whole grain bread and cereals, whole wheat pasta, brown rice, wild rice, pearled barley, and popcorn.
Cold-water fish including salmon, mackerel, halibut, flounder, lake trout, sardines, and herring, are rich in omega-3 fatty acids – healthy fats that play an essential role in the brain’s ability to recall information and function normally.
Curcumin, a yellow curry spice, is also believed to enhance the brain’s ability to recover following a traumatic event. Curcumin has displayed particular potency in preserving cognition and improve neuronal function in individuals who have Alzheimer’s disease.
Dark chocolate, the tastiest of the brain enhancing foods, is a powerful antioxidant, and can be beneficial in healing the brain following a traumatic brain injury as it contains several natural stimulants, including caffeine, which enhances focus and concentration, and stimulates the production of endorphins, which helps improve mood.
Can You Feel Pain in Your Brain?
Technically there are no pain receptors or nociceptors in the brain, so someone cannot feel pain in the brain. This phenomenon allows neurosurgeons to operate on the brain without anesthesia. There are however pain receptors in the coverings around the brain called the meninges, coverings on the bones, called periosteum and pain receptors on the scalp. When these pain receptors are activated it can feel like the pain is occurring in the brain. A common example of this is the sensation of “brain freeze” that occurs when someone eats ice cream too quickly. The phenomenon of brain pain can also occur as a result of sinus pain.
The brain also can fabricate a sensation of pain when no nociceptors are active, like a hand that has been missing for years. Since pain doesn’t always mean nociceptors are active, it’s possible that so-called “brain pain” is just the accidental byproduct of a yet-unknown set of interacting brain regions.
Is There a Cure for Brain Damage?
The outcome of anoxic brain injury depends on many factors including the extent of the damage and variables such as age, cultural background and drug and alcohol abuse.
If the injury has been mild or short-lived, there is a high probability that there will be full recovery to normal or near normal level of functioning. In all cases, the first line of treatment will include restoring a normal heartbeat, blood pressure and a good supply of oxygen to the victim. The rehabilitation of anoxic brain injuries is generally a gradual process. However, this is not always the case, and it is important to remember that cognitive recovery is possible.
As with other types of brain injuries people under 50 tend to do better in recovery from an anoxic brain injury. There is evidence though that older people do benefit from rehabilitation programs.
For newborn infants that suffered an anoxic brain injury during birth, there is evidence that hypothermia therapy for neonatal encephalopathy applied within six hours of the event improves outcomes for those individuals.
Anoxic Brain Injury Settlements and Verdicts
What is the settlement value of your anoxic brain injury case? There is no average settlement value for brain injury cases, much less anoxic brain injury claims. Having an average would not be of much help anyway. These cases are all so different. You are not going to find anything that will allow you to calculate the fair settlement value for your claim on the Internet. There are just too many variables at play. Still, looking at example settlement and verdicts and help you better understand the range of potential values for a claim if it is successful.
- AA Pro Ami v Hines (Colorado 2017) $2.1 million: The mother was 32 weeks pregnant when she went to the hospital due to respiratory difficulties. Doctors at the hospital negligently inserted a breathing tube, obstructing her airway. The mistake went unnoticed for 2 hours at which time doctors had to perform an emergency c-section delivery in response to the dangerously decreased oxygen levels. As a result, the mother suffered anoxic brain injury and died. The baby also suffered anoxic hypoxic brain injuries. The case was settled for $2.1 million dollars.
- Disabled Plaintiff v Defendants Roe (Massachusetts 2014) $4.6 million: The plaintiff went to the hospital for pain in her leg and was kept for observation. Her condition suddenly got worse and she was transferred to the ICU, but she was not intubated or given any antibiotics. She later coded for almost 15 minutes during which time she suffered an anoxic brain injury. It was later discovered that she actually had sepsis caused by a MRSA infection. The malpractice claims alleged negligent misdiagnosis and negligence in failing to intubate or give her antibiotics. Plaintiff’s brain injury left her completely disabled and reliant on 24-hour medical assistance. The case settled for $4.6 million.
- Riveria v USA (Texas 2013) $6.5 million: During labor the baby’s heart rate declined in apparent reaction to oxytocin but doctors resumed the drug eventually resulting in loss of oxygen causing severe anoxic brain injury. The injury left the child permanently dependent on a feeding tube and unable to speak.
- White v Mangra (Florida 2013) $38.5 million: Plaintiff was put under anesthesia for a chiropractic procedure and began experiencing bradycardia. Doctors opted to continue with the procedure anyway. During the procedure, the plaintiff suffered a cardiac arrest during which he stops breathing for 5 minutes. The five-minute loss of oxygen to the brain resulted in anoxic brain injury leaving plaintiff is a permanent vegetative state. The jury in Broward County found in favor of plaintiff and awarded damages that exceeded what the plaintiff was seeking.
- Tseng v Mazzocco (California 2011) $2.5 million: Malpractice claims alleged that anesthesiologist left plaintiff unattended and unmonitored during procedure resulting in respiratory failure. Loss of oxygen for a prolonged period caused anoxic brain injury. A jury in Los Angeles County awarded $1,800,000 in economic damages and $445,000 in pain and suffering.
Contact Miller & Zois About Brain Injuries
If you or a family member has suffered a brain trauma either at birth or in an accident because of the fault of someone else, you have every right to seek monetary compensation. Contact the personal injury attorneys at Miller & Zois to discuss your case and find out if you may be able to get legal compensation. We are focused in Maryland but we handle a dozen cases outside of Maryland at any given time in cases where the injuries are particularly significant. Call us at 1.800.553.8082 or submit a request for a free consultation.