Surviving Drowning May Still Result in Anoxia, a Form of Brain Injury

By Christina Eichelkraut

It’s already swimming season in Arizona. That means getting ready to cool off with a dip in the pool, or at least lounge in the sun poolside (or maybe lakeside, if you’re lucky).

Though the Brain Injury Alliance of Arizona would never want to be a wet towel – see what we did there? – as brain injury survivor advocates, we have a responsibility to offer a gentle reminder that swimming also carries the risk of drowning and – more to our point – near drowning. This is especially true for anyone who cannot swim who may accidentally fall into the water.

Every year, BIAAZ helps survivors of anoxic brain injury or ABI. Unlike traumatic brain injuries, which are caused by blunt force to the head or skull, an ABI stems from brain damage caused by the brain being completely deprived of oxygen for a period of time. After four minutes, brain cells begin to die, sometimes resulting in permanent brain damage.

Causes and Symptoms of Anoxic Brain Injury

It’s worth noting that anoxic brain injury is  different from hypoxia, which is when oxygen to the brain is low or restricted. Both conditions, however, can result in severe, lifelong brain injury.

An ABI is the most common outcome of children who survive near drowning. It can result in locked-in syndrome, where a person appears to be in a vegetative state but is aware of their own consciousness and surroundings. The 2017 study published in the scholarly journal Human Brain Mapping that discovered near-drowning ABI victims were locked-in and not vegetative was instrumental in changing the way these survivors received treatment and long-term care.

ABIs can range in severity from mild to severe. In mild cases, an almost complete recovery to normal occurs. In severe cases, a person may end up in a nonresponsive, vegetative state. In the middle of the spectrum, there can be anything from cognitive difficulties and some physical impairment, including seizures and paralysis.

Moderate ABI survivors may struggle with impulsivity or word choice but are able to function independently in terms of most daily life skills. Still, other symptoms may include memory issues, a general sense of brain fog, or mild issues with certain cognitive-motor functions like physical writing, but not full paralysis. Behavioral changes or difficulty regulating emotions is also not uncommon.

The severity of an ABI is will usually depend on how long the person’s brain was deprived of oxygen. As a general rule, the longer the oxygen deprivation, the more severe the impacts on speech, cognition and bodily function. However, even first responders can’t always accurately assess what a near-drowning survivor’s outcomes will be immediately after rescuing the person.

The length of time a person with an ABI who becomes comatose remains unconscious is also a general indication of how severe the brain injury will be.

Also, a person rescued from drowning may be revived and appear fine but then have symptoms of mild to moderate brain damage later on.

Although the results of anoxia are often similar to those that happen when a person has a TBI or other types of brain injury, because specific regions of the brain are more vulnerable to brain damage from lacking oxygen than others, there are key markers and differences in this kind of brain injury.

Still, like all brain injuries, not all symptoms occur in all cases. As the adage goes: If you’ve seen one brain injury, you’ve seen one brain injury.

Treatments for Anoxic Brain Injury

Treatment for non-comatose survivors is very similar to brain injury treatment in other cases, however. The focus is on restoring as much ability as possible within the first six months of injury. Although some incremental improvement may be possible a year post-injury, at that point, outcomes in people with anoxia appear to be fairly fixed.

Prevention of ABI

Still, many cases of anoxia can be avoided altogether.

Ensuring any swimming, boating or even bathing environments are safe can go a long way to ensuring no one has to survive drowning only to live with anoxia. Checklists like this can help prepare a safe, fun poolside area for everyone.

Never let children swim or play near water unsupervised, and be mindful of anyone—whether a child or adult—who can’t swim but is participating in water-based activities.

ABOUT BRAIN INJURY ASSOCIATION OF ARIZONA

The Brain Injury Association of Arizona (BIAAZ) is the only statewide nonprofit organization dedicated to improving the lives of adults and children with all types of brain injuries through prevention, advocacy, awareness and education. BIAAZ also houses the Arizona Brain Health Resource Center, a collection of educational information and neuro-specific resources for brain injury survivors, caregivers, family members and professionals.

What began in 1983 as a grassroots effort has grown into a strong statewide presence, providing valuable life-long resources and community support for individuals with all types of brain trauma at no charge.