Brain impact apnoea causes secondary brain injury.  The duration of the apnoea reflects the energy in the injury. We often see these patients in our trauma center as they come intubated. CT-scan can reveal structural brain damage or bleeding. In some pastients the CT-scan is “normal”. However, the brain may have suffered hypoxic injuries undetectable with this modality.

We should all be aware of this phenomenon and consider a MR-scan before we lighten the sedation. As always in patients with TBI; prevent secondary injury !

Readable article in Resuscitation by Wilson et al, august 2016: Impact brain apnoea – A forgotten cause of cardiovascular collapse in trauma.

Also, take a look at our previous post on Brain Impact Apnea.