Hydrocephalus, C2 fracture and GCS score 6

[jude49]

Hi, I am new here. I am from Macao. My friend (20 year old) had an accident and I am so desperate looking for helps and advice.

She had an accident on 13 May, hitting by a high speed van. She was found unconscious, not breathing, and no heartbeat for about 10 minutes. Her GCS score was 3. She has hydrocephalus , C2 fracture, leg and pelvic fracture. Her GCS score turned to 6 this week (26 May). Her family said she sometimes opens her eyes now. Her heartbeat, blood pressure, etc, are stable now. She has C2 fracture but recently she can breathe spontaneously with the assistance of the vent. Can I assume that she has no SCI? The doctors said she still has a chance of getting SCI. Now she still has hydrocephalus. We are worried that she may not wake up or become vegetative.

[SCI-Nurse]

So sorry about your friend. Did she get steroids to help prevent brain swelling? Did she have an inter-crainial pressure monitor inserted into her skull?? Was the hydrocephalus treated with a shunt or drain? What did the MRI show about any cord damage?

Unfortunately it is impossible to tell the outcome of her brain injury at this time. It may take months to determine if she is improving at all. The GCS is really not a valid tool for determining degree of brain injury after the original insult. During the recovery phase, something like the Rancho Los Amigos stages of coma are much more helpful.

Additionally it is impossible to tell at this point if she has spinal cord damage, and how much. An incomplete injury might still allow her to trigger a spontaneous breath on a ventilator.

Meanwhile, it is important that all care is taken to prevent pressure ulcers, contractures, pneumonia, excessive weight loss, and other complications that may hold back recovery.

Please come back and let us know how she is doing.

(KLD)

[jude49]

The doctors said her spinal cord injury may cause her to stop breathing at any time, and because of the limited resource in Macao here, her family is looking for some helps from other regions, HK or Taiwan for example. But many of them suggest praying instead of giving any advice. Thank you so much for your kind reply. I understand there is still too many uncertainties.

I am not with her family right now but I will be back to Macao tomorrow and directly talk with her family about your advice.
Once again thank you. I will be back if there is any news.

[jude49]

I met her family yesterday. They gave me a DVD containing her CT, X-ray and MRI data, hope that we can find some help from other hospital.

They said actually her breath and heartbeat stopped for 15 minutes, if CPR is included. Now her hydrocephalus is getting better and is almost gone now. Her eyes open spontaneously, and in response to speech, pain sometimes with tears. She also yawns and swallow saliva. In addition she has C2 fracture of dens with spinal cord compression, her skull (or C1, sorry I do not really understand it from the MRI) dislocated. Other details are not clear to me...

We are kind of helpless now, her doctors seem to be giving up and not providing any treatment. We are still looking for some experienced doctor from any other places, is there any approach for that?