| Anoxic brain injury came to most people's attention | | | | Generally injury will set in after a lack of blood flow |
| via one of the most notable cases in medical ethics in | | | | to the brain for around three to four minutes. |
| recent years. Terri Schiavo collapsed in 1990, | | | | Oxygen is crucial to the brain as it is used to |
| following respiratory and cardiac arrest, which led to | | | | metabolize glucose, which provides energy for all the |
| anoxic brain injury. She finally died in 2005 at the age | | | | body cells. Most of the brain's glucose is used to send |
| of 41, following a battle between her husband and | | | | impulses and keep cells alive. The damage ensuing |
| her parents about whether she should be allowed to | | | | from lack of oxygen leads to serious problems with |
| die. This battle eventually involved the President, the | | | | cognition, emotions and movement. In Terri's case it |
| Pope and an enormous number of legal actions. | | | | led to a persistent vegetative state. As with |
| The changes found in her brain were typical of those | | | | traumatic brain injury, hypoxic/anoxic brain injury may |
| suffered in extreme anoxic-ischaemic encephalopathy. | | | | occur along a spectrum from very mild to very |
| There was extensive damage to nearly all brain | | | | severe. |
| regions, including the cerebral cortex, the thalami, the | | | | Recovery is similar to that of other types of brain |
| basal ganglia, the hippocampus, the cerebellum and | | | | injury, however it may be lessened as hypoxic/anoxic |
| the midbrain. | | | | injury occurs to the neurons in the brain, instead of |
| Throughout the cerebral cortex, the large pyramidal | | | | the more repairable pathways that link neurons |
| neurons that comprise some 70 percent of cortical | | | | together. The most rapid recovery tends to be in |
| cells - critical to the functioning of the cortex - were | | | | the first six months, tapering off towards the end of |
| completely lost in Terry's brain. The pattern of | | | | the second year. |
| damage to the cortex, with injury tending to worsen | | | | The effects of anoxic brain injury can vary. Cognitive |
| from the front of the cortex to the back, was | | | | problems include short term memory loss, problems |
| typical. There was marked damage to the important | | | | with making judgments and analyzing information, |
| relay circuits deep in the brain (the thalami). Areas of | | | | communication disorders and visual problems. |
| the brain particularly vulnerable to lack of oxygen | | | | Movement disorders are common, including lack of |
| include the Purkinje's fibres of the cerebellum and the | | | | coordination, spasticity, tremors and impaired ability to |
| parieto-occipital cortex, which play a large role in | | | | adjust the body's position. There can also be |
| coordination and movement. The hippocampus is also | | | | behavioral problems, which may be more severe than |
| affected, which is one of the major structures | | | | with other kinds of brain injury. They may include |
| responsible for memory consolidation. | | | | psychotic, delusional and personality disorders. |
| Terri Shiavo's anoxic brain injury seems to have been | | | | The effects of anoxic brain injury have serious and |
| caused by a cardiac arrest. There can be many other | | | | permanent consequences for both the sufferer and |
| causes though, including respiratory arrest, drowning, | | | | his or her carers and family. |
| carbon monoxide inhalation and poisoning. | | | | |