Brain trauma generally relates to accidents, falls, and violence, where the brain sustains injury, either physically or sometimes emotionally. However, Dr N.K. Venkatramana, Founder-Chairman of Brains Super Speciality Hospital, states that most of the time it is physical injury that causes it.
He points out that unfortunately India has highest number of road traffic accidents and the highest number of deaths related to them globally, says Dr Venkatramana. He refers to this as a “physical brain drain”. Furthermore, he mentions the associated disability, explaining that it will create a significant disease burden and social impact.
Crucial Golden Hours
Dr Venkatramana explains that the golden hours are the initial few hours following a primary brain injury, spinal cord injury, stroke, or even a medical emergency like a cardiac event. He says this period is crucial because numerous events occur after the initial incident, which can complicate it.
He elaborates that all these factors can complicate the primary brain injury and are known as preventable secondary complications. While the initial accident causing the primary brain injury might not always be avoidable, Dr Venkatramana believes that most head injuries are largely preventable.
During these golden hours, Dr Venkatramana suggests that acting promptly can certainly prevent secondary complications, leading to five key benefits: a reduction in the death rate, decreased disability, fewer complications, shorter hospital stays, lower medical expenses, and a potentially good quality of life after treatment and recovery.
In the golden hour, Dr Venkatramana stresses the importance of a very good rescue system to move people to a safe location soon after an accident, thus preventing further damage at the scene. He highlights that the most essential thing is checking the A, B, C: A for airway, B for breathing, and C for circulation, which he likens to fundamental education.
Life-Threatening Situations
Dr Venkatramana indicates that if the airway, breathing, and circulation are compromised, it signifies a life-threatening situation. He emphasises that these individuals need immediate protection at the scene to ensure these vital functions are maintained until they reach the hospital. Failure to do so and simply transporting them blindly can lead to permanent brain damage during transit. According to Dr Venkatramana, the most critical aspect of protecting the golden hours is ensuring the ambulance arrives in time.
Dr Venkatramana notes that brain trauma today has a wide range of causes. He identifies road traffic accidents, particularly involving two-wheelers in India, as a significant problem due to factors like not wearing helmets or seatbelts, disregarding traffic rules, and driving erratically. Drunken driving, he adds, is a major contributor to these accidents. Secondary factors include poor vehicle condition, bad roads, and adverse weather.
In addition to traffic accidents, Dr Venkatramana mentions that falls and violence are also becoming major causes of brain trauma. He differentiates emotional trauma, where people emotionally hurt each other, as something treatable that can heal over time.
Brain Recovery
Dr Venkatramana explains that once brain damage occurs, there is currently no replacement for the brain, and it must recover on its own. He points out that certain areas of brain function can recover as the brain takes over lost functions using undamaged surrounding areas. This phenomenon is called neuroplasticity, and the brain has the ability to regain some abilities over time, though it will never be the original state.
Therefore, Dr Venkatramana concludes by emphasising the importance of both primary prevention and effective management during the golden hours to avoid secondary brain damage, minimise brain damage overall, and promote recovery.
