No life without a brain, surgeon cautions

A neurosurgeon says the brain controls everything a living person does.

He says brain injuries, including being hit on the head, must be avoided at all costs

The brain is an essential organ and must be safeguarded at all costs. Injury to it can lead to paralysis or even death.

Neurosurgeon Lee Ogutha says no one survive without a brain, while the loss of a significant portion of the brain may result in severe complications such as loss of speech, vision and in some cases, death, depending on the extent and location of the damage.

Dr Ogutha describes the brain as the body’s central control system. “Survival without a brain, without a functional brain, is impossible. Even in cases of brain death, where the heart may still be beating, the person has lost all vital brain functions, particularly in the brain stem. In such a situation, survival is not possible,” says Dr Ogutha.

While it is possible for someone to survive with half a brain, he notes that the chances of survival are minimal and heavily depend on which parts of the brain are lost. “The brain controls everything we do—speech, vision, movement, heart rate, mood, thinking, and even hormonal regulation,” he explains.

He says the brain function is highly compartmentalised, meaning damage to one area can impair specific functions while leaving others unaffected. He says brain injuries are not only caused by bullets, but can also result from rubber bullets or any object that strikes the head with force.

“Any object, if thrown or projected with force, can penetrate the skull and damage the brain,” he warns, noting that even objects that do not penetrate the skull can cause brain injury.

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He noted that once the brain is injured, some functions may not be restored. “When brain tissue has come out of the brain, it cannot go back, and it will die because it will no longer be supplied with blood, so there is no oxygen or nutrition,” he tells The Standard in an interview.

“But when the brain comes out, it cannot be restored and that area that is injured does not grow back- it forms a scar. Even if someone heals with a scar, what is lost cannot be retrieved,” he emphasises.

Concerning the complexity of surgery of a patient who survived a police shooting in Nairobi, Ogutha maintains he is not privy to the extent of injury, but in general, head injury is potentially life-threatening. Ogutha says treatment and operating on a patient with a head injury depend on the type of injury.

There are two types of head injuries, open and closed. In an open injury, the bone is broken and there may be exposed brain, whereas in a closed injury, the skull is intact but there is injury to the underlying brain, for example, bruising, bleeding, and swelling. However, regardless of what type of head injury a patient has, they require careful evaluation to determine the best type of treatment.

A neurosurgeon, therefore, ensures that they protect the dura (brain-protective layers, which consist of three layers: the dura mater, arachnoid mater, and pia mater).

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Depending on the type of injury, surgery may involve restoring broken bones, stopping bleeding, removing blood clots, removing bone fragments or bullets, and replacing the dura with a patient’s soft tissues or an artificial replacement.

“One mission of brain surgery when a bullet is lodged into the head is to retrieve the bullet,” says Ogutha. “Sometimes, the bullet can fragment into smaller pieces as it enters the skull, and a neurosurgeon will retrieve the fragments.”

Injury to other parts of the head for example the face may not be as immediately life threatening as injury to the brain, but can still be dangerous because of tissue swelling that can block the airway, the doctor says. 

He says a head injury is potentially life threatening and early intervention within the first few hours of injury makes a big difference in outcomes and survival of a patient.