Breathing problems are a dangerous complication of traumatic brain injuries (TBI). They most commonly arise after an injury to the brain stem. To help you understand these issues better, this article will cover the causes and types of respiratory problems that occur after TBIs, as well as some of the most effective treatments.

What Causes TBI Respiratory Problems?

Damage to the areas of the brain that are in charge of breathing will lead to respiratory problems. There are two areas of the brain that help you to breathe: the brain stem and the motor cortex.

The motor cortex controls all voluntary muscle movements, which can include breathing. The brain stem, on the other hand, plays a pivotal part in controlling involuntary functions such as breathing, swallowing, and heart rate.

Three sections – the midbrain, the pons, and the medulla – make up the brain stem. Of the three, the medulla is the one most responsible for regulating your breathing, though the pons plays a crucial role as well.

In the following section, we’ll discuss how the brain controls breathing.

How Does the Brain Control Breathing?

Most of the time, unless you consciously focus on your breath, the brain stem controls your respiratory rate.

Inside the brain stem is a vast network of neurons that are connected to your intercostal muscles, the muscles between your ribs that contribute to your ability to breathe. The brain stem sends signals to these muscles, telling them when to inhale and exhale. This creates your breathing rhythm.

Additionally, the brain stem adapts your breathing rate in response to changes in the environment. For example, the medulla analyzes the carbon dioxide and oxygen levels in the bloodstream and adjusts your breathing rhythm accordingly. And the pons can control how long your inhale lasts by sensing how wide your lungs stretch.

As you can see, breathing depends on easy communication between nerve cells in the brain stem and the rest of the body. If an injury disrupts any part of this network, then serious respiratory problems can result.

Types of TBI Breathing Problems

There are several types of TBI respiratory problems that a person can experience after sustaining an injury to the medulla. We’ll take a closer look at them below.

1. Apneustic Breathing

Apneustic breathing refers to problems with exhaling air. It’s caused by damage to the pons. When a person has apneustic breathing, they take deep breaths in but do not completely exhale. This is because the pons can’t detect how far the lungs are expanding, and so it struggles to determine how much air needs to be let out.

Eventually, this condition generates high amounts of carbon dioxide in the bloodstream, which can lead to dizziness, headaches, loss of consciousness, or even seizures.

2. Irregular Respiratory Rate

If the medulla becomes damaged, this will cause it to have trouble detecting carbon dioxide (CO₂)levels. There are two main respiratory rate problems you can experience after TBI:

• Quick, shallow breaths.
• Slow, infrequent breaths.

Both upset the balance of CO₂ and oxygen in the body and can cause life-threatening complications.

3. Apnea

Apnea refers to a complete stop of a person’s breathing rate. It can occur following a brain injury that compresses the medulla. The most common type of apnea is sleep apnea, which, as the name suggests, occurs when the person is asleep. Because apnea can lead to hypoxia and further brain damage if it lasts too long, it’s crucial to get it treated as soon as possible.

4. Labored Breathing (Dyspnea) and Agonal Breathing

Labored breathing describes when a person struggles to use their breathing muscles and can barely get enough air. It occurs when there is damage to the intercostal nerves.

Labored breathing often gets confused with agonal breathing, but they are two separate conditions.

Agonal breathing means that the person is in respiratory distress and is not getting enough oxygen to their brain. Signs of agonal breathing include:

• Gasping
• Snorting
• Moaning
• Labored breathing

If your loved one displays these signs, call 911 immediately. Agonal breathing can sometimes last several hours, but without medical intervention, it can lead to serious brain damage and even death.

Now that you understand potential respiratory problems that may occur after TBI, let’s discuss treatment.

Treating Respiratory Problems After Brain Injury

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