Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Life expectancy for TBI
Forum: The Neurology and Neurosurgery Forum
Topic Area:
Posted by CCF NEURO MD on June 09, 1997 at 10:15:40:
In Reply to: Re: Life expectancy for TBI posted by CCF Neuro MD on June 09, 1997 at 10:04:57:


: :
: I have a 27 year son with a tramatic brain injury due from a car accident,almost 8 years ago. He lives in a nursing home, I visit him everyday.He is a level 3 on the ranchos scale. He is slowly progressing. Dec. the 3rd he spoke a whole sentence and a couple words after that. Great Responses! Since that he as said answered to yes and no questions about 3 times! He smiles,turnes his head to me when I speak to him and loves funny jokes. He will laugh out loud if it is funny enough. He watches T.V. and will listen to music. He has some contractures and has spasticity in his left arm. I take him out of the nursing and bring him home or to his Aunt's house as much as I can. We work with him everyday,talk, exercise and stimulate him in every way possible. He is tube-fed. My question is how long can a person live like this, on tube-feeding. His health is really good. No breathing problems,no skin break-downs , but can't swollow. Any information that might give me anything else we can do would be greatly appreciated. I still have great hope for my son! Thank you very much. Patricia Osborne



: The brain injury your son sustained would be categorized as a severe brain injury. The damage that resulted was most likely multifactorial. In general in brain injury that results from a car accident one will have a primary injury which involved a contusion of the brain (bruising) at the site of impact and at the site opposite to the impact due to the acceleration of the brain at impact. There also is diffuse axonal injury which results from the shearing forces. Although this damage is on the microscopic level it often results in significant loss of consciousness and neurologic impairement. There is also petechial (microscopic bleeding) and there may or may not be a large amount of bleeding (subdural, epidural, subarachnoid or hemispheric hemorrhage). The above may lead to secondary insults which include brain swelling (edema) resulting in high intracranial pressures leading to shifting of brain tissue and compromising blood flow to the brain. There may also be other complications such as lack of blood flow to the brain if the patient was not breathing after the injury occurred before they received medical care. After the initial acute care phase, the majority of people will undergo extensive rehabilitation. The amount of function that is recovered is highly variable but does relate to the degree of injury that was sustained. Most dramatic improvements are seen within the first 6 months. Thereafter, the recovery is slower but may continue up to a year or more. As you have stated you continue to see improvements in your son even 8 years after the injury. Younger patients do better in general due to the ability of the younger brain to recovery to some extent. I suspect your son may be continuing to learn new things. However, the extent of recovery will still be very limited. It sounds like your son has received wonderful care from both you and the facility he is at. His life expectancy should be normal as long as he does not develop any complications. He can be continued on tube feedings indefinetly because it supplies all his required daily nutrients and water. These patients may get in to trouble if they develop infections, commonly lung-from aspiration of tube feeds, and urinary tract infections. These infections may become serious (systemic) if they go unnoticed. Bed sores or blood clots in the leg may also lead to significant problems

I hope this information has been helpful to you. I will also be submitting some support group address to you in a subsequent answerif it does not appear in this submission.

National Head Injury Foundation

400 chapters. Founded 1980. Advocacy organization providing services to persons with brain injury
and their families and educating professionals. Aims to increase public awareness through a network
of state associations and support groups. Information and resource network, prevention programs,
technical assistance, seminars, conferences, literature. Magazine. Write: National Head Injury
Foundation, 1776 Massachusetts Ave., Suite 100, Washington, DC 20036. Call 800-444-NHIF
(family helpline) or (202)296-6443; FAX (202)296-8850.
- coma brain tumor injury disabled disability
This information is provide for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.

The Perspectives Network

International network. Founded 1990. Emotional and informational support and networking for
survivors of brain injury, their families and professionals through coordination of non-location
dependent peer support groups. Quarterly magazine, peer communication network, workshops,
phone support, exchange of information from professionals and survivors. Write: The Perspectives
Network, P.O. Box 1859, Cumming, GA 30128-1859. Call 800-685-6302 (voice mail),
(770)844-6898 (voice/FAX).
- head injury coma disabled disability
mailto:dktaylor@tbi.org
http://www.tbi.org

Brain Trauma Foundation
523 East 72nd St
NY, NY 10021
212-772-0608

Head Injury Hotline (aka Phoenix Project)
PO Box 84151
Seattle. WA 98144
206-621-8558
Email: Brain@headinjury.com
Web site: http://www.headinjury.com/brain

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