My brother was driving me home after our gathering, somehow our topic of conversation came to a scene in a drama -THE WALKING DEAD SEASON 2. .Both of us had been crazy of this english drama for more than one month.
"Why is it Carl jerking and shivering on the bed of Hershell after been shot by gun and what is the medical condition known as?" my bro asked. :)
"The condition is known as seizure " I managed to answer the name of CARL'S condition. But I was still not sure with the causes of seizure. But one thing for sure was seizure can be related to nervous system , eg the BRAIN
"what is it caused by? is it due to shock?" he kept asking.
"shot ,ya agree with you" i replied.
"Bro, not shot ...but shock..." he corrected me. I THINK I REALLY NEED A HEARING AID TO HELP ME LOL
"oh i see...i think it may be due to..." i stopped half way. Because inside my heart i was not sure with the causes of it, how can the brain and spinal cord be damaged while Carl was been shot on his abdominal part??
"har...due to what...??" he asked for complete sentence.
"due to.....hmm..i am not sure bro ....sorry man...i am not good in pretending, i would rather say i donnt know if i am not sure...." i said ,hoping he wonnt keep asking the same question to me. I really unsure with the causes of seizure and i donnt like to bluff especially in front of my best friend.
I was once been taught that seizure can be due to brain damage ;and the common sense is the damage might be due to
a)) direct brain damage like shot // hit at head or infection by bacterial
b))and indirect brain damage due to shortage of oxygen
I was suspecting infection in the brain due to the invasion of bacterial from the air-exposed wound of Carl abdomen. Deep inside my heart i was confused ,
at one hand i was thinking of brain infection and on the other hand i was thinking of blood brain barrier.
How can a bacterial and viruses be able to enter the brain when the brain is still protecting by the strong tight blood brain barrier! Remark: blood brain barrier is a special layer of tissue around the brain with tight junction which seperate the brain with the blood vessel and act as a filter to prevent the enter of bacteria and viruses. It is strong enough to prevent brain infection unless there is a wound on head but remember? Carl is not shot at head!
So i decided not to say this out as an explanation.
Then i was thinking whether seizure can be caused by indirect damage exp: due to brain hypoxia (lacking of oxygen supply to brain)
But i can briefly still remember that Carl was given blood tranfusion from Rick (Group A; RH+ve).
"Is it due to shock?" my friend interrupted my thinking
"u heard of shock? shock is like someone who lost his limb due to serious injury ..." He explained to me.
WOW MY FRIEND KNOW QUITE ALOT. THIS SHOWN THAT HE READ AND HEARD QUITE ALOT TOO...
"ya i learnt about shock...but there are quite a number of shock bro.." i replied.
Shock can be classified into 3 types:
- hypovolaemic shock eg blood lost OR fluid lost as stated above
- cardiogenic shock eg heart problem.
- distributive shock(can be further divided into septic shock, anaphylactic shock and neurologic shock)
Direct damage due infection is unvalid due to the healthy undamaged blood brain barrier , the reason of hypovolaemic shock cannt be established too due to the frequent blood tranfusion from Rick to Carl
"bye bye, see u bro...good night' my last sentence to my bro, when his car reached in front of my house.
I had reached my home but question from my friend still hovering inside my brain....
Then ,i tried to linked wound infection with shock suggested by my friend. BINGO! Infection of the wound had caused the blood vessels of carl to be dilated and expanded, this is like the case of hypersensitivity *** To READ MORE ON HYPERSENSITIVITY ON MY BLOG PLZ FOLLOW THIS LINK http://jiajuin0409.blogspot.com/2011/12/allergic-reaction-by-law-jia-juin.html
This also tell us that the volume and lumen of blood vessels increased due to vasodilation BUT the volume of blood fluid inside the vessel remained constant, thinking the blood vessel as a hose or pipe, blood as water and heart as the power pump for water, the common sense here is when the pipe dilated while volume of water remained ,the pressure inside the hose or pipe must had been decreased, this is why carl blood pressure decreased ,blood cannt be able to reach his brain and the brain must be suffering from serious hypoxia due to oxygen shortage, as a normal response the brain will order the heart to contract and release faster so that the blood can be deliver faster and efficiently to the brain, in order to compensate the need of oxygen supply, This is why although carl blood pressure dropped greatly, his heart still pumping fast and hard (this situation is known as tachycardia) .The frequent nerve impulses from the brain to make the contraction and relaxation of myogenic cardiac muscle also resulting in the seizure of other body muscles. This type of shock is known as anaphylactic shock, and the management is as below:
1.Fluid resuscitation or infusion ***TO READ MORE ABOUT FLUID RESUSCITATION PLZ follow this link http://jiajuin0409.blogspot.com/2011/12/fluid-resuscitation-and-hypovolemic.html
2.mediacation:
a))adrenaline
b))antihistamine
c))glucorcorticoid
d))B agonist
3.oxygen supply (that is why the doct needed ventilator )
But one thing i am still not sure is how can a patient suffering from brain hypoxia due to anaphylactic shock be able to wake up , talk and flash back on the beautiful deer,
this shown that he is still under conscious and be able to use his higher brain fuction like memory and speech this *doesnt support anaphylactic shock and hypoxia very much T.T*, since most of the time a patient with brain damage due to the lackage of oxygen supplied from shock will remain blur ,speechless, numb and worse remained unconcious!
No comments:
Post a Comment