Traumatic brain injury

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Definition

What is traumatic brain injury?

Traumatic brain injury occurs when an external mechanical force causes brain dysfunction.

Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.

Mild traumatic brain injury may cause temporary dysfunction of brain cells. More serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain that can result in long-term complications or death.

How common is traumatic brain injury?

Traumatic brain injury can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of traumatic brain injury?

The signs and symptoms of mild traumatic brain injury may include:

Physical symptoms

  • Loss of consciousness for a few seconds to a few minutes
  • No loss of consciousness, but a state of being dazed, confused or disoriented
  • Headache
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Difficulty sleeping
  • Sleeping more than usual
  • Dizziness or loss of balance

Sensory symptoms

  • Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell
  • Sensitivity to light or sound

Cognitive or mental symptoms

  • Memory or concentration problems
  • Mood changes or mood swings
  • Feeling depressed or anxious

Moderate to severe traumatic brain injuries can include any of the signs and symptoms of mild injury, as well as the following symptoms that may appear within the first hours to days after a head injury:

Physical symptoms

  • Loss of consciousness from several minutes to hours
  • Persistent headache or headache that worsens
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Dilation of one or both pupils of the eyes
  • Clear fluids draining from the nose or ears
  • Inability to awaken from sleep
  • Weakness or numbness in fingers and toes
  • Loss of coordination

Cognitive or mental symptoms

  • Profound confusion
  • Agitation, combativeness or other unusual behavior
  • Slurred speech
  • Coma and other disorders of consciousness

Infants and young children with brain injuries may lack the communication skills to report headaches, sensory problems, confusion and similar symptoms. In a child with traumatic brain injury, you may observe:

  • Change in eating or nursing habits
  • Persistent crying and inability to be consoled
  • Unusual or easy irritability
  • Change in ability to pay attention
  • Change in sleep habits
  • Sad or depressed mood
  • Loss of interest in favorite toys or activities

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Always see your doctor if you or your child has received a blow to the head or body that concerns you or causes behavioral changes. Seek emergency medical care if there are any signs or symptoms of traumatic brain injury following a recent blow or other traumatic injury to the head.

The terms “mild,” “moderate” and “severe” are used to describe the effect of the injury on brain function. A mild injury to the brain is still a serious injury that requires prompt attention and an accurate diagnosis.

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes traumatic brain injury?

Traumatic brain injury is caused by a blow or other traumatic injury to the head or body. The degree of damage can depend on several factors, including the nature of the event and the force of impact.

Injury may include one or more of the following factors:

  • Damage to brain cells may be limited to the area directly below the point of impact on the skull.
  • A severe blow or jolt can cause multiple points of damage because the brain may move back and forth in the skull.
  • A severe rotational or spinning jolt can cause the tearing of cellular structures.
  • A blast, as from an explosive device, can cause widespread damage.
  • An object penetrating the skull can cause severe, irreparable damage to brain cells, blood vessels and protective tissues around the brain.
  • Bleeding in or around the brain, swelling, and blood clots can disrupt the oxygen supply to the brain and cause wider damage.

Common events causing traumatic brain injury include the following:

  • Falling out of bed, slipping in the bath, falling down steps, falling from ladders and related falls are the most common cause of traumatic brain injury overall, particularly in older adults and young children.
  • Vehicle-related collisions. Collisions involving cars, motorcycles or bicycles — and pedestrians involved in such accidents — are a common cause of traumatic brain injury.
  • About 20 percent of traumatic brain injuries are caused by violence, such as gunshot wounds, domestic violence or child abuse. Shaken baby syndrome is traumatic brain injury caused by the violent shaking of an infant that damages brain cells.
  • Sports injuries. Traumatic brain injuries may be caused by injuries from a number of sports, including soccer, boxing, football, baseball, lacrosse, skateboarding, hockey, and other high-impact or extreme sports, particularly in youth.
  • Explosive blasts and other combat injuries. Explosive blasts are a common cause of traumatic brain injury in active-duty military personnel. Although the mechanism of damage isn’t yet well-understood, many researchers believe that the pressure wave passing through the brain significantly disrupts brain function.

Traumatic brain injury also results from penetrating wounds, severe blows to the head with shrapnel or debris, and falls or bodily collisions with objects following a blast.

Risk factors

What increases my risk for traumatic brain injury?

There are many risk factors for traumatic brain injury, such as:

  • Children, especially newborns to 4-year-olds
  • Young adults, especially those between ages 15 and 24
  • Adults age 75 and older

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information

 

How is traumatic brain injury diagnosed?

Because traumatic brain injuries are usually emergencies and because consequences can worsen swiftly without treatment, doctors usually need to assess the situation rapidly.

  • Glasgow Coma Scale: This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person’s ability to follow directions and move their eyes and limbs.
  • Information about the injury and symptoms:
  • How did the injury occur?
  • Did the person lose consciousness?
  • How long was the person unconscious?
  • Did you observe any other changes in alertness, speaking, coordination or other signs of injury?
  • Where was the head or other parts of the body struck?
  • Can you provide any information about the force of the injury? For example, what hit the person’s head, how far did he or she fall, or was the person thrown from a vehicle?
  • Was the person’s body whipped around or severely jarred?
  • Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions) and brain tissue swelling.
  • Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of the brain. This test may be used after the person’s condition has been stabilized.
  • Intracranial pressure monitor: Tissue swelling from a traumatic brain injury can increase pressure inside the skull and cause additional damage to the brain. Doctors may insert a probe through the skull to monitor this pressure.

How is traumatic brain injury treated?

Mild traumatic brain

Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms. He or she also may have follow-up doctor appointments. The doctor will indicate when a return to work, school or recreational activities is appropriate. It’s best to avoid physical or thinking (cognitive) activities that make things worse until symptoms have resolved. Most people return to normal routines gradually.

Immediate emergency care

Emergency care for moderate to severe traumatic brain injuries focuses on making sure the person has an adequate oxygen and blood supply, maintaining blood pressure, and preventing any further injury to the head or neck. People with severe injuries may also have other injuries that need to be addressed. Additional treatments in the emergency room or intensive care unit of a hospital will focus on minimizing secondary damage due to inflammation, bleeding or reduced oxygen supply to the brain.

Medications to limit secondary damage to the brain immediately after an injury may include:

  • These drugs reduce the amount of fluid in tissues and increase urine output. Diuretics, given intravenously to people with traumatic brain injury, help reduce pressure inside the brain.
  • Anti-seizure drugs. People who’ve had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury. An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Additional anti-seizure treatments are used only if seizures occur.
  • Coma-inducing drugs. Doctors sometimes use drugs to put people into temporary comas because a comatose brain needs less oxygen to function. This is especially helpful if blood vessels, compressed by increased pressure in the brain, are unable to deliver the usual amount of nutrients and oxygen to brain cells.

Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems:

  • Removing clotted blood (hematomas). Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue.
  • Repairing skull fractures. Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain.
  • Opening a window in the skull. Surgery may be used to relieve pressure inside the skull by draining accumulated cerebral spinal fluid or creating a window in the skull that provides more room for swollen tissues.

Most people who have had a significant brain injury will require rehabilitation. They may need to relearn basic skills, such as walking or talking. The goal is to improve their abilities to perform daily activities. Therapy usually begins in the hospital and continues at an inpatient rehabilitation unit, a residential treatment facility or through outpatient services. The type and duration of rehabilitation varies by individual, depending on the severity of the brain injury and what part of the brain was injured. Rehabilitation specialists may include:

  • Physiatrist, a doctor trained in physical medicine and rehabilitation, who oversees the entire rehabilitation process, manages medical rehabilitation problems and prescribes medication as needed
  • Occupational therapist, who helps the person learn, relearn or improve skills to perform everyday activities
  • Physical therapist, who helps with mobility and relearning movement patterns, balance and walking
  • Speech and language pathologist, who helps the person improve communication skills and use assistive communication devices if necessary
  • Neuropsychologist, who assesses cognitive impairment and performance, helps the person manage behaviors or learn coping strategies, and provides psychotherapy as needed for emotional and psychological well-being
  • Social worker or case manager, who facilitates access to service agencies, assists with care decisions and planning, and facilitates communication among various professionals, care providers and family members
  • Rehabilitation nurse, who provides ongoing rehabilitation care and services and who helps with discharge planning from the hospital or rehabilitation facility
  • Traumatic brain injury nurse specialist, who helps coordinate care and educates the family about the injury and recovery process
  • Recreational therapist, who assists with time management and leisure activities
  • Vocational counselor, who assesses the ability to return to work and appropriate vocational opportunities and who provides resources for addressing common challenges in the workplace

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage traumatic brain injury?

The following lifestyles and home remedies might help you cope with traumatic brain injury:

  • Join a support group. Talk to your doctor or rehabilitation therapist about a support group that can help you talk about issues related to your injury, learn new coping strategies and get emotional support.
  • Write things down. Keep a record of important events, people’s names, tasks or other things that are difficult to remember.
  • Follow a routine. Keep a consistent schedule, keep things in designated places to avoid confusion, and take the same routes when going to frequently visited destinations.
  • Take breaks. Make arrangements at work or school to take breaks as needed.
  • Alter work expectations or tasks. Appropriate changes at work or school may include having instructions read to you, allowing more time to complete tasks or breaking down tasks into smaller steps.
  • Avoid distractions. Minimize distractions such as loud background noise from a television or radio.
  • Stay focused. Work on one task at a time.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: June 16, 2017 | Last Modified: June 16, 2017

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