Acquired brain injury (ABI) is any injury to the brain that occurs after birth, in contrast to congenital brain conditions present from birth. It encompasses a wide range of causes including stroke, traumatic brain injury (TBI) from falls or road accidents, brain tumours, infections such as meningitis or encephalitis, and hypoxic-ischaemic injury resulting from loss of oxygen supply to the brain. Cardiac arrest is one of the most common causes of hypoxic ABI in adults.
When the heart stops during a cardiac arrest, blood flow to the brain ceases within seconds. Brain cells begin to die after approximately four to six minutes without oxygen, and the longer the period of cardiac arrest and resuscitation, the greater the potential for brain injury. The pattern of injury depends on the duration of cardiac arrest, the effectiveness and speed of resuscitation, the body temperature during and after the event, and individual factors including age and pre-existing health. Targeted temperature management (TTM) in the intensive care unit is used to limit the extent of secondary brain injury in the hours following a cardiac arrest.
The effects of acquired brain injury after cardiac arrest vary enormously. Some survivors have no lasting neurological impairment. Others experience cognitive effects such as memory difficulties, problems with attention and concentration, fatigue, emotional changes and executive function difficulties, which can affect daily life, work and relationships long after physical recovery. A minority of patients sustain severe brain injury resulting in prolonged disorders of consciousness.
Rehabilitation for ABI involves a multidisciplinary team including neuropsychologists, occupational therapists, physiotherapists, speech and language therapists and specialist nurses. The Headway charity provides support for people living with ABI and their families. SCA UK connects survivors experiencing cognitive effects with peer support and signposts to relevant specialist services.
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