C1 & C2 Injury

[momsurvive]

Hello, I am new here and in need of some information as my family and I are in complete sadness and really scared.

My mother was in a car accident. Her heart stopped twice. They opened her chest to restart heart again & repair an organ. She had nonstop seizures 12+ hours. She has a dislocated C1 and C2 because the ligaments snapped and there is also spinal injury. She sometimes reacts to blinking & tears sometimes roll down when she hears us. We feel she still understands. The doctors tell us that they are pretty sure she has no brain activity or awareness. She is not sedated anymore & only is being given pain medicine and seizure medicine.

My questions are:
Has anybody experienced someone not being aware for several days and then regained consciousness?
Does reactions like tears mean she can still hear us?
She can't move or tries to move any part of her body, is there any chance that she will not be paralyzed completely?

Thank you,
Gabriela

[SCI-Nurse]

So sorry you had to find us. What hospital is she in? If she is at UC Irvine, see if Suzy Kim, MD is available to consult on her case.

Spinal cord injury at C1-2 does not cause brain damage, unless it causes loss of blood circulation through the two vertebral arteries to the brain stem. These arteries do not supply the higher regions of the brain responsible for cognition or consciousness. They do supply parts of the brain (the brain stem) that control blood pressure, breathing, temperature control and other vital functions, so if occluded, they can cause cardiac arrest and loss of the ability to breathe.

Amazingly, some people do have little or no damage to the spinal cord even with a serious C1-2 fracture/dislocation. If the cord is seriously damaged, then it would be very unlikely that full return of function (movement or sensation of the arms and legs) would occur. It could take time to determine if that is the case, and without a conscious patient, it is nearly impossible to determine.

Cardiac arrest and long-lasting seizures, though, esp. in an elderly person, can cause higher cognitive dysfunction and coma and serious brain damage or even death. She should be having tests for brain activity. This is required in order to determine brain death. Has she had these tests? Has a second opinion been obtained from a neurologist who is not currently treating her?

People do certainly wake up from coma, although this is not as likely in an elderly person as it would be in a child or young adult, and would not be likely if the tests for brain death were positive.

Tears can occur due to reflex activity, and may not be related to whether or not she can hear you. Does she open her eyes at all? This would not be controlled by the spinal cord nor by the brain stem.

My heart goes out to you. This is a difficult decision to make for your family. Please be sure that you have requested an Ethics Team consultation to help you and her health care team make the best decision possible. Please come back and ask more questions if you have any.

(KLD)

[gjnl]

Hello "momsurvive,"

I just want to welcome you and your family to the Care Cure Community and let you know how very sorry I am that your mother has suffered such a traumatic and serious accident.

It is difficult for any of us here who are not physicians or nurses to give you any advice about the prospects for your mother's recovery. Listen carefully to the attending physicians and seek outside opinions if you are not comfortable with what you are hearing. I wish all of your well.

All the best,
GJ

[LindaT]

I am so sorry to hear this has happened to your family.

[Bonnette]

I, too, am so sorry that this has happened and wish you and your family the best. May you be blessed with excellent medical counsel and great wisdom and vision in the days to come. Welcome to the CareCure community, momsurvive.

[BillMiller823]

Hello Gabriela,

I just want to say that life CAN still be good, even as a C1-2 quadriplegic (I've been one for over 14 years now). And it sounds like it's too early to determine what her condition is or will be. Prayers for recovery.

Advice wise, I'd pay close attention to SCI-Nurse KLD's response above.

God bless!

Bill Miller

[momsurvive]

Thank you all for your support.

It has been an emotional and tiring week. She does have spinal injury also, but they didn't tell us the extent of it. It doesn't seem to be very severe. I will ask.

How do they determine if the C1/C2 caused loss of blood circulation through the two vertebral arteries to the brain stem?

She has not had a brain activity test. I will ask about it. Their goal was to slowly reduce the medications to see what if any activity she had. They were very negative with their predictions when they removed the sedation and she didn't regain conscious. Does it automatically mean that she won't regain conscious if she doesn't do so when they take her off all the medicines?

Yes her eyes open sometimes and sometimes blink, but it seems like it is very hard for her to blink. Her tears came out when we talked to her. One time her eyes were dry and when we put my toddler (her favorite) on the phone speaker her eyes filled with lots of tears on that instant and rolled down. Does sound increase reflex activity? I honestly felt in my heart that she was listening to us.

2 days ago was really scary because her heart rate went down to 40, and her seizures started so she since has stopped opening her eyes since she is back on higher dosage of seizures medicine and other medicines.

She also moves her tong slowly nonstop, is this reflux or any ideas what it is?

Religious wise our faith is strong and we continue to pray and will not give up until her heart stops beating, but it seems like we don't see the light through the dark tunnel. We are a strong tight family and my mother is the center of it. She is only 56 years only, completely devoted to God and was coming back from Church when she got hit by a drunk driver.

Thank you for your prayers. Thank you Bill for your encouragement. We will love our mom regardless of her condition in the end, but have faith that she will be okay.

God Bless,
Gabriela

[LindaT]

Thanks for the update Gabriela, It is too early to know what is going to happen by the sounds of things. Waiitng is the hardest part.

[Mombo]

Gabriela, I am so sorry for your mother and your family!! I will keep all of you in my prayers!

[momsurvive]

We are still waiting which is the hardest part. We haven't seen any progress yet. They put a feeding tube and the breathing tube in her neck. She opens hers eyes, but not like she did the first time. We used to be able to communicate with her blinking at us, but now she opens them blindly and they move back.

Her foot moved, but I was told it was just reflex. Her tong moves nonstop but they don't know what it is.

Very frustrating and depression is starting to hit family. We keep praying which is all we can do for now.

Thank you all for your support. I will keep you posted.

[Bonnette]

Oh, how agonizing for all of you! It is so hard when a loved one's condition has to be interpreted. Yes, do keep us posted.

[Scaper1]

My sincere sympathies. I have a similar injury as your mom, so it hits very close to home. I don't want to give you false hope, but I was pretty out of it mentally for quite a while before I regained full cognitive function. It's not uncommon with such high injuries. I truly hope things will improve for you all.

[momsurvive]

Thank you for your thoughts. The doctors told us that she may be paralyzed below the eyes down. We have a lot of faith and pray that this will not be the case. We know God has great plans for her. We are very religious, but are in agony mainly because we don't want her to suffer and we have to ask ourselves the questions of what would she want. We feel that as long as she has life; it is not our call to make what quality of life one is given. We will love our mom and will always take care of her regardless of her condition. If you are C1-2 quadriplegic, or have a loved one in this condition can you please tell me how you would feel please if you were a C1-2 quadriplegic and below the eyes as well.

Thank you,
Gabriela

[SCI-Nurse]

Where is she? Has she been seen by a physiatrist? Unless she also has a brain injury that would cause "locked in" syndrome, I don't see how he could decide this. A C1 SCI doesn't cause any facial paralysis or loss of speech by itself. It can result in ventilator dependency and loss of use of the arms and legs. Please request a PM&R consult.

KLD

[truly]

Oh dear, I was so sorry to read about your mom's condition. I can only imagine how difficult this must be for you. I hope you get the answers you seek so you can make the best decisions for her. My heart goes out to you.