‘Don’t Write’: Advice From Brain Injury Experts After Bob


It seemed like an ordinary fall: Actor and comedian Bob Saget hit his head on something and maybe fell asleep without thinking about anything, his family said on Wednesday.

But the gruesome results – Mr Saget, 65, died from blunt head trauma on January 9, a coroner ruled – underscored the dangers of traumatic brain injuries, even if they didn’t initially seem like cause for alarm.

In 2019, nearly 61,000 deaths were related to traumatic brain injuries. According to the Centers for Disease Control and Preventionand about half of hospitalizations due to head trauma are due to falls.

Brain injury experts said on Thursday that Mr. Saget’s case is relatively rare: People with severe head injury are expected to have obvious symptoms such as headaches, nausea or confusion. And they can usually be saved by surgeons who open their skulls and suppress bleeding in the brain.

But doctors said some conditions put people at higher risk for the kind of impairment that Mr. Saget experienced.

Doctors said a risk factor as serious as any is simply being alone. A person with a head injury may lose touch with their usual decision-making capacity and may become confused, agitated, or unusually sleepy. These symptoms, in turn, may stand in the way of getting help.

And although there was no indication that Mr. Saget was taking blood thinners, experts said the drugs could greatly accelerate the type of bleeding after a head injury that forces the brain down and compresses the centers that regulate breathing and other vital functions. More Americans are being prescribed these drugs as the population ages.

Mr. Saget was found unresponsive in a hotel room in Orlando during a weekend stand-up comedy show. The local coroner said Wednesday that his death was caused by “blunt head trauma” and that “his injuries were most likely caused by an unwitnessed fall”.

The coroner said there was no evidence of illegal drugs in his system.

Head of neurosurgery at Houston Methodist, Dr. “If you have a head injury, you can never – and I mean never – be on your own for the first 24 hours,” said Gavin Britz.

Dr. Britz said she would advise people who have suffered a serious blow to the head to see a doctor or ask someone else to monitor their symptoms and even wake them up occasionally at night for monitoring.

Brain injury experts also stressed that the presence of symptoms often indicates a need for medical attention.

D., an emergency room physician and concussion specialist at the University of Rochester Medical Center. “You don’t need to call the doctor after a minor blow,” said Jeffrey Bazarian. On the other hand, “If you hit your head and have persistent symptoms like headaches or confusion, that requires medical attention—especially if you’re on blood thinners,” he said.

The CDC warns that traumatic brain injuries in older people can be overlooked when symptoms overlap with those seen in other common conditions such as dementia.

People aged 75 and older account for roughly one-third of hospitalizations for head trauma, the agency saidBut experts said they tend to be extra cautious with any patient who is at least 60 years old. CDC data show that men are at higher risk than women.

Neither Mr Saget’s family nor the coroner gave details on how the head injury killed him Wednesday.

The family stated that Mr. Saget accidentally bumped the back of his head. Associate professor of neurosurgery and pediatrics at the Stanford University School of Medicine. Angela Lumba-Brown said the back and sides of the skull tend to be less strong than the front, making blows in these areas more likely to cause bleeding. .

Still, significant blows to any part of the head can cause problems, he said.

Doctors said there were several possible scenarios for how Mr Saget died. They also warned that important details of his case were missing, such as whether he had any underlying conditions and the precise nature of his injuries.

In one scenario, more commonly in younger patients, they said, someone had sustained a blow to the head severe enough to cause a fracture of the skull, tearing a blood vessel or artery between the skull and the thick lining that covers the brain. The result is an epidural hematoma and bleeding can be fatal. In some such cases, there is a range in which patients feel well.

it was the injury that killed actress Natasha Richardson After what appeared to be a small drop on the ski slope for beginners in 2009.

Dr. “Maybe you get a little headache and go to bed and the blood clot expands,” Britz said. “Over time it gets so big that you get brainstem compression.”

Another scenario, the doctors said, is a fall that ruptures the tiny vessels between the membrane that covers the brain and the brain itself. These types of injuries are more common in older patients — in part, a result of the shrinking brains of people as they age and the prevalence of blood thinners, doctors said.

In these cases, known as subdural hematomas, symptoms can develop rapidly or within weeks.

Brain experts said the risks of head injury become more pronounced as Americans get older, and in many cases start taking blood thinners after a heart attack or stroke.

Mount Sinai Health System director of neuroemergency management, Dr. “As our population ages, we must be aware of the risks posed by using blood thinners,” said Neha Dangayach. “If you fall or hit your head, don’t wipe it.”

Still, doctors said these head injuries are often easily treatable and deaths are often completely preventable.

A neurosurgeon at the Stanford University School of Medicine, Dr. Jamshid Ghajar, Rules for the treatment of brain injuriesHe said he operated on a 100-year-old boy with a severe head injury.

“I had your blood drawn,” said Dr. Ghajar, “and woke up right after.”



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