Traumatic brain injury (TBI), also known as the cranial injury occurs when external force such as a blow, jolt, or other head injury causes brain damage. Mild brain injury may cause temporary dysfunction of brain cells and more serious injury results in bruising, bleeding and physical damage to the brain. Half of these brain injuries lead to hospitalization of the patient. Survivors of TBI may have inability with certain aspects for a few days, or the disabilities may last for their whole life.
The cranial injury can be mild, moderate or severe depending on the extent of brain damage. The symptoms may not be apparent for some days or weeks following the injury.
In the case of a mild injury, the following symptoms may be seen:
Headache or neck pain
Ringing in the ears
Nausea
Dizziness
Tiredness
Moderate to severe injury may produce the below symptoms:
Nausea or repeated vomiting
A headache that worsens and does not go away
Slurring of speech
Dilated pupils
Inability to wake up from sleep
Convulsions or seizures
Weakness or numbness in the arms and legs
The causes of TBI include falls, accidents, sports injuries, and firearms. Firearm injuries are usually fatal. The other causes are:
A blast from an explosive device
A severe jolt (either rotational or spinning)
An object penetrating the skull
A severe blow
Gunshot wounds, domestic violence or child abuse
Every individual is at risk of having TBI but the risk is little high in children (aged around four years), young adults (aged between 15 and 24) and older adults (aged 75 years and above). Nearly half of the head injuries occur while driving motor vehicles.
TBI can lead to several complications, either immediately or little later after the injury. The complications are more in the case of severe injuries. Complications with TBI include:
Infections can occur due to the entry of the bacteria through the penetrating wounds
Blood vessel damage, which can lead to the formation of blood clots, stroke or other problems
Fluid buildup can occur in some cases and leads to an increased pressure and swelling in the brain
Nerve damage may occur if injury occurs to the base of the skull
Intellectual problems may arise if significant injury has occurred
Behavioral changes such as difficulty with self-control, and lack of awareness of abilities
Emotional disturbances like depression, anxiety, mood swings
Communication problems
Altered consciousness
Seizures
As it is an emergency situation, an immediate diagnosis needs to be done. Glasgow Coma Scale (GCS) is used to assess the severity of brain damage using a 15-point scoring. Higher the scores, severe is the damage. Imaging tests are performed to detect the exact locations.
| Test type | Purpose of the test |
|---|---|
Computerized tomography (CT) scan |
Creates detailed images of the brain using X-rays To visualize the presence of fractures, bleeding, bruising, clotting or swelling |
Magnetic resonance imaging (MRI) |
Creates detailed images of the brain using radio waves and magnets Usually, it is used after the person has got stabilized |
Intracranial pressure monitoring |
To measure the pressure inside the skull |
Traumatic brain injury treatment depends on how severe the injury is.
Mild injury:It does not require any treatment or may be relieved with painkillers. However, the patient should be monitored regularly to check for the worsening of symptoms.
Moderate to severe injuries:Immediate medical attention is required for such cases. They are treated in the ICU (Intensive Care Unit) or emergency ward to minimize secondary damage to the brain. The following medications may be recommended:
Intravenous Diuretics– to remove excess fluid and reduce the pressure in the brain
Anti-seizure drugs– given during the first week of the injury to prevent further damage to the brain
Coma-inducing drugs– to reduce the oxygen demand of the brain if required
Surgery–more than half of the severely-injured patients require surgery to remove or repair hematomas or contusions, skull fractures, open a window in the skull to relieve pressure and to remove blood clots
In the case of severe injuries, rehabilitation may be required which includes care from the following specialists:
Physical therapist
Physiatrist
Occupational therapist
Recreational therapist
Neuropsychologist
Rehabilitation nurse
Speech and language therapist
Vocational counselor
You can prevent the brain injuries by taking the below measures:
Wearing seat belts while traveling
Avoiding the use of alcohol or drugs when you have to drive
Wearing helmets
Getting your eyes regularly checked up
Special care must be given to older adults to prevent the falls by:
Installing handrails in the bathroom
Improving lighting of the house
Keeping home and stairs clean
Also prevent head injuries in children by installing window guards, avoiding them to play on fire escapes or balconies.
