Doctor touts girl's progress, notes healing can be slow

The hospital helps families understand the implications of brain injury.
AKRON -- When Dr. Philipp Aldana first saw Emily Ayers, it was in the emergency room of Akron Children's Hospital on the evening of March 7, 2003.
Emily, then 11, had survived a horrendous car crash and was in a coma when she arrived at the hospital. Dr. Aldana, assistant director of pediatric neurosurgery, quickly assessed that an attempt to save Emily's life would require emergency surgery.
Emily had suffered a traumatic brain injury -- a depressed skull fracture that caused brain swelling, bruising and bleeding. The front part of her skull fractured, and the broken bones were pressing into her frontal lobe -- the forehead area of her brain.
He said about 200 children each year are treated at Akron Children's Hospital for brain injuries -- so many each year that the hospital has a support group for families of brain-injured children -- and about 10 percent of those are severe.
'Amazing' recovery
Dr. Aldana said of the brain-injured children who have been his patients, Emily's injury was the worst among the survivors. Most children with brain injuries as severe as Emily's don't survive, he said.
"It's amazing how much recovery she has made compared to how she was when she came in," Dr. Aldana said. "It was a few weeks before we were certain she'd survive."
Emily did not emerge from the coma and start breathing on her own until 22 days after the crash. Even though she was no longer in a coma, however, she was mostly unresponsive and still not talking.
"I did not know anything about who Emily was as a person," Dr. Aldana said. "Her family told me she was a bright and bubbly girl and she was always smiling, but I couldn't see that because of her injuries. I did not get to know her until weeks later."
Dr. Aldana said a major mission of the hospital is education. A big part of his mission and that of all the employees who deal with brain-injured children is education about recovery from traumatic brain injuries.
Slow healing
A neurological injury is the slowest, most difficult type of injury to heal, Dr. Aldana explained. He said much of the recovery relates to brain functions such as appropriate reactions to events, memory and decision-making.
"It has been a year now since her injury, and I think Emily will keep getting better and we will still see some recovery," he concluded.
After a recent examination, Dr. Aldana talked with Emily's mom, Cynthia Ayers, and told her to schedule a follow-up exam in September.
He said the hospital's support-group network is important because families need help to understand the effects of a brain injury and to explain those effects to relatives and acquaintances.
Relearning the basics
Emily had to learn to walk and talk again and had months of therapy to redevelop coordination and other motor skills. She has returned to public school in Leetonia, and teachers and administrators are aware of the effects of a brain injury on social behavior and the learning process.
After a traumatic brain injury, behavior can be altered and personality changed. Memory lapses and mood swings are common.
Dr. Aldana said much of the recovery from a brain injury occurs after the injured person appears to be physically recovered, so a person who does not know a brain-injured person well may be surprised by a memory lapse or inappropriate behavior.
"We're not certain if Emily will ever be 100 percent recovered," Dr. Aldana said. "With any brain injury, there is some permanent loss because you can't grow new brain cells. That's why education is so important, so people can understand and know how to help."
tullis@vindy.com