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Comment by golemotron | Hacker News Reader

What are the interventions?

As Cian pointed out: high-dose steroids.

Why do they help?

I don't know if it's conclusively known, other than inflammation in response to the injury tends to exacerbate the damage to the inner ear.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012465/

A friends daughter got a brain injury from a car-pedestrian accident. He learned a lot, and told me his take away: If you hit your head and have any concern about it, take Ibuprofen to prevent swelling/inflamation and drive to Ann Arbor (we're in Michigan but that's over an hour away). The first part made sense, the second he said that town and UofM are known for treating that kind of thing. He has them in such high regard that it's worth the drive not even knowing who you're going to see ahead of time!?!?!?

Hm -- the website of Mayo Clinic says that you should avoid Ibuprofen if you might have a concussion, as they may increase the risk of bleeding.

"Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding."

See: https://www.mayoclinic.org/diseases-conditions/concussion/di...

One of the challenges in first aid treatment for stroke is “is it ischemic or hemorrhagic?”. The symptoms are similar, but the treatments almost the reverse of each other. Do you want to increase clotting to stop the bleeding, or decrease clotting to keep an existing brain clot small?

Sometimes (for example if it would take hours to bring the patient to a MRI/CT machine) an educated guess as to the answer is the optimal strategy.

Wow, that's really good info. So I guess the answer is get to a hospital asap where they can do some imaging.

"Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding."

Wow. Did I misremember and he said Tylenol (acetaminophen)? This is bothering me now, I don't like to carry bad bits of wisdom around!

Prescription Ibuprofen actually carries a Black Box Warning about increased stroke and heart attack risk in general. The OTC version never got the updated warning.

Prevent Inflammation of course.

And NAC to prevent oxidative damage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808688/

As odd as it may sound, Amphetamine is a key part of 'one of the most promising pharmacological strategies studied for recovery after stroke'. https://www.ncbi.nlm.nih.gov/m/pubmed/14960125/

Protip: NAC prevents hangovers. I take one before and one after if I'm expecting an epic night out. The downside is, I don't get drunk so all the drink spend is wasted money. The upside, I come across as impervious instead of naturally being the lightweight of the group. Very useful when hanging out with alcoholic salespeople if you need to work the next day.

Test it out before you need it because the taste/smell makes some people puke like crazy for half an hour...

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