What is brain trauma?
Brain trauma is basically related to all the accidents, falls, and violence wherein the brain gets injured, either physically or even sometimes emotionally. Now, most of the time it’s the physical injury that causes it. And today, unfortunately, India has the highest number of road traffic accidents and the highest number of deaths related to road traffic accidents in the world. That’s the physical brain drain, as I call it. The second part of it is the associated disability. It causes a huge disease burden, you know, the social burden.
And what is the golden hour? How did you come up with this concept?
So, golden hours are the first few hours after, you know, primarily a brain injury or a spinal cord injury or even a stroke or a medical emergency, including a cardiac emergency. You know, it essentially means that’s the crucial time wherein a lot of events take place following the primary event, complicating the primary event.
All these things can complicate the primary brain injury. Now, we call these the preventable secondary complications. Unfortunately, the accident has already happened—that causes the primary brain injury—and is not avoidable in a way, but all head injuries by and large are preventable. So that is why it is called the golden hours. And during these golden hours, if we can act, we can certainly prevent all the secondary complications. Thereby, we reap five benefits. We can reduce the death rate. We can reduce the disability. We can reduce the complications. We can reduce the hospital stay. We can reduce the medical expenses, and the quality of life after the treatment, after recovery, can be pretty good.
What can be done in the golden hour?
So in the golden hour, what is important is that we should have a very good rescue system, you know, soon after the accident, and people should be rescued to a safe place so that their secondary damages in the same place can be avoided.
And then what is important, the most essential thing, is checking the A, B, C. You know, one is A for airway, B for breathing, C for circulation. These A, B, Cs are fundamental, like our education in school. Now, if the airway, breathing, and circulation are compromised, that means we are dealing with a life-threatening situation.
And these are the people who need to be protected right there from the scene itself to ensure these three are sustained until they reach the hospital. If that is not done, and they are simply blindly carried to the hospital, then during transportation itself, the brain is going to be permanently damaged. The most important thing to protect the golden hours is that the ambulance should reach in time.
What are the common causes of brain trauma in everyday life?
Brain trauma is due to a wide variety of possibilities. Road traffic accidents, especially two-wheelers in this country, are becoming a big issue—not wearing helmets, not wearing seatbelts, not following traffic rules, zigzag driving. All these are possible causes. Drunken driving is one of the major reasons for these accidents. Secondary factors include poor vehicle condition, bad roads, and adverse weather conditions.
In addition, we have a lot of falls. Violence is also becoming a major cause. And emotional trauma is an entirely different thing where people abuse each other and emotionally hurt themselves. But that is treatable. It can heal after a while.
After impact, what can be done to enhance longevity after trauma?
Once brain damage happens, we do not have any replacement for the brain today. It has to recover on its own. Certain areas of brain function can recover by the brain taking over the extra functions using the surrounding areas that are not damaged.
So this phenomenon is called neuroplasticity, and the brain has that ability over a period of time to regain certain abilities, but it can never be the original. Therefore, we must emphasise primary prevention as well as management in the golden hours so that we can avoid secondary brain damage, minimise brain damage, and promote recovery.
