Like so many people, I'm poised to hear good news from Courtney's family and supporters any day now. But when? Will she be okay? How long before she wakes up, and what does a longer sleep stage mean for her recovery? I did some research.
If you read no further than this paragraph, read this:
1001 loving ways to help a patient, family, or caregiver. It gives wonderful advice. Novel readers may want to read
Range of Motion, a wonderful novel of coma recovery by Elizabeth Berg. I read it years ago.
Facts and stats... Stats on traumatic brain injury can be a bit scary. But the medical experts are quick to point out that
each case is unique and progresses in its own way, at its own pace. "People with moderate to severe injuries have made remarkable recoveries" (braininjury.net).
- Doctors are saying that Courtney's fitness and age weigh heavily in her favor. It's true -- people under the age of 20 rebound miraculously, and patients under 40 years of age have a significantly better long term prognosis, because their body is better at repairing the damage. Take note, oldsters among us. Outcomes for older folks are not so great.
- The outcome of a patient can be associated with their best response in the first twenty-four hours after injury. We don't have a lot of detail, but it's great that doctors are reporting small improvements at this stage.
- Pupil reaction, age, CT-defined brain lesions/injuries, and motor scores (on tests body reactivity) are strong indicators for recovery (see PLoS Med, 2008).
- The majority of individuals who survive a period of coma eventually regain consciousness. Data from the Traumatic Coma Data Bank indicate that of 650 patients who experienced a vegetative state [note: I don't think Courtney is in this category] after a brain injury, only 14% were released from the hospital in a coma. And of those, about half had regained consciousness after one year's time. (from the Traumatic Coma Data Bank -- see Caregiver.org for more)
- Approximately 20% of survivors of severe TBI remain unresponsive for at least one month.
- Annually 300,000 individuals suffer brain injuries severe enough to require hospitalization, with 99,000 resulting in a lasting disability.
Many equestrians have made remarkable recoveries from bad falls. Remember that Darren Chiacchia was
in a coma for about a week after his fall -- and despite dire predictions (e.g., he'll never walk), he is now competing every weekend. Everything I've read just confirms the frustration and mystery around brain injury and coma recovery -- there is so much we don't know.
RESOURCES Lots of info at
caregiver.org Prognosis of traumatic brain injury from braininjury.net
More stats in
The Diagnosis of Stupor and Coma By Fred Plum, Jerome B. Posner, chapter on Prognosis in Coma.
Traumatic brain injury by Donald Marion
Read about the Glasgow Coma Scale at
braininjury.com. The eye, verbal, and motor responses of a brain injury survivor 24 hours after the accident can indicate—to some degree—the eventual outcome. For example, a person with a best score of 3 to 4 24 hours following the accident is likely to die or remain in a vegetative state. Those with scores in the 11 to 15 range, on the other hand, have a high likelihood—close to 90 percent—of making an almost full or full recovery.
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