Brain Injury
A blow or jolt to the head can cause traumatic brain injury. The blow causes damage to the brain. Some injuries are focal, or in one area of the brain. Others are diffuse, or in more than one area of the brain.
Injuries can range from a mild concussion to severe injury, coma, and death. If you have a mild concussion, you may have no long-term side effects. If you have a moderate to severe brain injury, side effects can range from headache and confusion to personality changes and seizures.
Fortunately, brain injury is one of the most preventable brain disorders. Improved use of car safety belts and child car seats has helped reduce the number of brain injuries. So has greater use of helmets in biking and other sports. Efforts to reduce drinking and driving have also helped.
There have been considerable efforts to recognize and prevent brain injuries in sports. Coaches and parents have learned the signs of concussion. They have also learned that student athletes must get quick medical care.
Severe brain injuries affect both the injured people and their families. It is a period of great trauma and change. Over time, often with the help of counseling, you begin to develop a new sense of self. Then you make decisions based on that new reality.
Types of traumatic brain injury:
There are several types of brain injuries, depending on the type of force and amount of force that impacts the head.
In open head injury, the skull is fractured or displaced.
In closed head injury, there is no skull fracture.
Concussion is the mildest and the most common type of brain injury. Trauma from an impact or a sudden momentum or movement change can cause a concussion.
A contusion is a bruise on the brain caused by a skull fracture.
In a coup-contrecoup injury, bruises are both at the site of impact and on the opposite side of the brain. This occurs when the impact forces the brain to hit the opposite side of the skull. This can happen in car accidents after high-speed stops. It also happens in Shaken Baby Syndrome.
Shaken Baby Syndrome occurs when a baby is shaken forcefully. Different parts of the brain can be injured in this way. Shaking is so dangerous for babies due to their small size, large relative head size, and undeveloped necks, skulls, and brains.
Second Impact Syndrome can occur when a person sustains a second brain injury before the symptoms of the first injury have healed. The second injury can happen from days to weeks after the first one. It is also called recurrent traumatic brain injury.
What Is the Cause?
Half of all brain injuries are due to transportation-related accidents. These can include car, motorcycle, and bicycle accidents, as well as injuries to pedestrians. About 20 percent of brain injuries are due to violence. This can include firearm use and child abuse. For people age 75 and older, brain injuries are most often caused by falls.
What Are the Symptoms?
Symptoms of a brain injury can be mild to severe, depending on the amount of damage. Some symptoms show up right away. Others may not appear until several days or weeks after the injury.
Immediate Signs of Concussion:
- Any loss of consciousness
- Impaired attention: vacant stare, delayed responses, inability to focus
- Slurred or incoherent speech
- Lack of coordination
- Disorientation
- Emotional reactions out of proportion
- Memory problems
If the following symptoms occur, hours or even days or weeks later, consult a neurologist:
- Persistent headache
- Dizziness / vertigo
- Poor attention and concentration
- Memory problems
- Nausea or vomiting
- Fatigue easily
- Irritability
- Intolerant of bright lights and / or loud noises
- Anxiety and / or depression
- Disturbed sleep
- Seizures
- Physical, cognitive or behavioral impairments that last for months or are permanent
- Prolonged unconscious state
- Coma
It’s important to remember that the treatment and recovery process is different for everyone. No two brain injuries are alike.
Treatment begins at the time of the accident or incident. A brain injury is an emergency. Medical personnel try to stabilize the person. They also work to prevent further injury. They make sure oxygen gets to the brain. They also make sure there is enough blood flow. Blood pressure must be controlled.
About half of all severely injured people will need surgery. This may be to remove or repair a hematoma. A hematoma is bleeding in or around the brain. Some people may need a ventriculostomy. This procedure drains fluid from the brain.
After the emergency treatment, people may receive care in an intensive care unit in a hospital. Once they are stable, they may move to the subacute unit of the hospital or to a rehabilitation hospital.
At this point, people follow many paths toward recovery. There are many options for rehabilitation. These can include:
- Day treatment
- Outpatient therapy
- Home health services
- Independent living programs
- Neurologist
- Physiatrist (physical medicine specialist)
- Physical therapist
- Occupational therapist
- Rehabilitation nurse
- Speech/language pathologist
- Neuropsychologist
- Social worker/case manager
Rehabilitation should be tailored to each person. It should be based on the individual’s strengths and capacities.
There is much that is still unknown about the brain and how it heals and relearns tasks. As we learn, new treatment methods are being developed.
Credit: National Institute of Health.