Traumatic Brain Injury & Its Impact on Brain

Traumatic brain injury happens when a sudden, powerful blow or jolt to your head or body causes damage to your brain. In such cases, the brain collides with your skull which apparently results in nerve fibre tear and bleeding.

The injury can even happen when any object like a bullet or smashed piece of the skull penetrates your brain tissue.

If the traumatic injury is mild, it will have a temporary effect on your brain. However, if the injury is very severe, it can result in bleeding, bruising, physical damage within the brain and torn tissues. It can even lead to disability, coma, amnesia, long-term impairment or death in certain cases.

The severity of the traumatic brain injury depends on the affected part of the brain, the extent of damage and if it is restricted to a precise location or widespread.

Treatment module for traumatic brain injury is also determined based on the injury type and part of brain as affected.

Symptoms of Traumatic Brain Injury

Traumatic brain injury is known to cause a range of physical and psychological effects. The signs and symptoms can either appear within 24 hours of the injury or in some cases, the symptoms can surface in days or weeks, post the injury.

In some cases, the symptoms are very subtle while in a few cases, there can be no symptoms but the condition tends to become worse in a later stage.

Let’s have a look at the different symptoms based on the injury type:

Mild traumatic brain injury

• Loss of consciousness
• State of being dazed, baffled or disoriented
• Nausea
• Fatigue
• Problems with speech
• Dizziness or loss of balance
• Blurred vision
• Ringing in the ears
• Sensitivity to light or sound
• Memory or concentration problems
• Feeling depressed or anxious
• Mood changes or mood swings

Moderate to severe traumatic brain injuries

• Persistent headache
• Repeated vomiting
• Convulsions or seizures
• Drainage of clear fluids from nose or ears
• Numbness in fingers and toes
• Loss of coordination
• Agitation
• Slurred speech
• Coma

Traumatic brain injury symptoms in children

Infants and young children who happen to suffer from traumatic brain injuries usually are not able to communicate about symptoms like headaches, confusion and sensory problems. If a child has suffered a traumatic brain injury, he or she will display the following symptoms:

• Change in the eating or nursing habits
• Easy irritability
• Seizures
• Persistent crying
• Changes in ability to pay attention
• Changes in the sleep habits
• Sad or pessimistic mood
• Drowsiness
• Loss of interest in cherished toys or activities

If your child had received a blow to head or body which has brought in certain behavioral changes, you should make it a point to consult the doctor without any delay. Emergency medical care will be needed if there is any sign of traumatic brain injury after the recent blow to the head.

Causes of Traumatic Brain Injury

As stated above, traumatic injury is mostly caused due to a sudden, violent blow or any traumatic injury to the head. The intensity of damage normally depends on many factors, like the type of the injury as well as the force of the collision.

Some of the mostly known causes of a traumatic brain injury happen to be:

Falls: Falls from a bed, a ladder, in the bath, and down stairs, are some of the common ways you can encounter a traumatic brain injury, especially in the older adults and young children.

Violence: This includes gun shot wounds, child abuse, domestic violence, and other types of assaults. Another common cause of traumatic brain injury in babies occur due to shaken baby syndrome, which is caused by violent shaking.

Sports injuries: Traumatic brain injuries that are caused due to sports can include injuries encountered because of different sports like lacrosse, football, soccer, boxing, baseball, skateboarding, hockey, and various other high-impact sports. The sports injuries are mostly common in the youth.

Vehicle-related accidents: Accidents that involve cars, bikes or bicycles, also happen to be the common causes of traumatic brain injury.

Explosive blasts and various battle injuries: Explosive blasts are also among the common causes of traumatic brain injury that mostly occurs to the active-duty military personnel. The injury can even occur due to penetrating wounds, serious blows to the head with armament or debris, or bodily collisions with the objects after a blast.

Risk factors with traumatic brain injury

Though traumatic brain injuries are often a result of sudden blows to the head, some age groups, however, stand vulnerable to such injuries. These include:

• Children, particularly newborns to 4-year-olds
• Young adults, especially between ages 15 and 24
• Adults who are 60 years old or above
• Males in any age group

Complications Associated with Traumatic Brain Injury

Along with the consequences of traumatic brain injury, you even have to face some of the complications associated with it. Depending on the fact whether the injury is mild or severe, the risk of complications also increases.

Some of the commonly known complications associated with traumatic brain injury include:

Altered consciousness: Be it a mild or severe traumatic brain injury, it can lead to extended or permanent changes in your state of consciousness, responsiveness or awareness. There will be distinct states of consciousness which would include:

Vegetative state: Extensive brain damage can lead you to the vegetative state wherein you will be unaware of the surroundings but you will open your eyes, respond to the reflexes, and make sounds or move. In some cases, the vegetative state can even become permanent. But in most of the cases of traumatic brain injury, people enter the minimally conscious state.

Minimally conscious state: It is a condition wherein you experience acutely altered consciousness. However, you will experience certain signs of self-awareness or awareness about the environment. It can even be a changeable state from a coma to vegetative, and in some cases it can even transit to greater recovery.

Coma: You will be unconscious in this state, totally unaware of your surrounding and will not be able to respond to anything. Coma usually occurs because of the widespread injury damage to the different parts of the brain. In some cases the person can recover from a coma in few days or few weeks. But in some cases, the person can even enter the vegetative state.

Brain death: When there is no measurable activity in the brain and the brainstem, this is called brain death. In a person who has been declared brain dead, removal of breathing devices will result in cessation of breathing and eventual heart failure. Brain death is considered irreversible.

Physical Complications

Some of the physical complications associated with traumatic brain injury include:

Headaches: One among the commonly associated physical complications with traumatic brain injury happens to frequent bouts of headaches. You will start experiencing headaches in a week’s time post the injury and it can last for several months.

Fluid buildup in the brain or hydrocephalus: The spaces in your brain can get filled up with cerebrospinal fluid in some people, post the traumatic injuries. This can even lead to increased pressure as well as swelling in the brain.

Infections: Fracture of the skull or penetrating wounds lead to tearing of the layers of protective tissues, called meninges surrounding the brain. As the protective tissue gets torn, the bacteria make their way into the brain and lead to infections. An infection of the meninges (meningitis) if not treated timely, can even spread to other parts of the nervous system.

Seizures: In some people, traumatic brain injury even leads to the occurrence of seizures. Usually, seizures are likely to occur either in the early stages of the injury or after many years. Seizures that keep on repeating are known as post-traumatic epilepsy.

Damage to blood vessel: Many of the small or large blood vessels present in the brain can also get damaged due to the traumatic brain injury. This damage can lead to stroke, blood clots or various other problems.

Vertigo: Some people suffer from vertigo, frequent feeling of dizziness, post a traumatic brain injury.

Traumatic brain injuries which occur at the base of your skull can lead to nerve damage, which emerge directly from your brain. Cranial nerve damage can lead to:

• Paralysis of facial muscles or loss in sensation on the face
• Hearing loss
• Swallowing problems
• Altered sense of smell
• Loss of vision
• Dizziness
• Altered sense of taste
• Ringing in the ear

Intellectual Complications

Traumatic brain injury even has a impact on the cognitive, thinking, skills. And it is experienced by a few people who suffer from such injuries. Because of the injury in brain, you may find it hard to focus and take much more time in processing the thoughts. It can further lead to various problems with your intellectual skills, inclusive of:

• Attention or concentration
• Cognitive problems
• Learning
• Reasoning
• Decision-making
• Memory
• Judgment
• Executive functioning problems
• Problem-solving skills
• Multitasking
• Organization
• Planning
• Beginning or completing tasks

Other Problems

Apart from the physical complications and intellectual problems, traumatic brain injury can affect you in a number of ways. Even your language and communication skills can get hampered because of traumatic brain injury. The complications can include conflict, annoyance, and misunderstanding. Some of the communication problems include:

• Cognitive or thinking problems
• Trouble in comprehending speech or writing
• Trouble with speaking or writing
• Incompetence in organizing thoughts and ideas
• Difficulty in following and taking part in conversations

It can even affect your social problems, which include:

• Problem with taking turns or selecting a topic in conversations
• Trouble in changing the tone, pitch or giving emphasis while expressing the emotions
• Problem in comprehending the nonverbal signals
• Difficulty in reading the cues from listeners
• Trouble with initiating or stopping conversations
• Inefficiency in using the muscles that required in forming words (dysarthria)

Some of the changes posts a traumatic injury are even linked to the changes in your behavior, which include:

• Difficulty in self-control
• Not able to know your abilities
• Risky behavior
• Trouble in in social situations
• Verbal or physical outbursts

In certain cases, people even experience emotional changes like mood swings, depression, anxiety, anger, insomnia, irritability and lack of emotions for others.

There are associated sensory problems as well, which include:

• Enduring ringing in the ears
• Trouble in recognizing objects
• Blind spots or double vision
• Damaged hand-eye coordination
• A bitter taste
• Bad smell or difficulty smelling
• Skin tingling, pain or itching
• Trouble with balance

Degenerative Brain Diseases

As per studies, recurrent or severe traumatic brain injuries can increase your risk of suffering from degenerative brain diseases. A degenerative brain disorder is likely to cause progressive loss of brain functions, which includes:

Alzheimer’s disease, it majorly causes gradual loss of memory and other thinking skills.

Parkinson’s disease, a gradually developing condition which leads to movement problems, like tremors, severity and slow movements.

How to Prevent Traumatic Brain Injuries?

To prevent traumatic brain injuries, you have to make it a point to cut down the risk by practicing the following measures:

Seat belts and airbags: You should always make it a point to take care of your safety while driving. Make it a point to wear seat belt and if there is a small child, he or she should also be made to wear the child safety seat.

Avoid drunk driving: Driving under the influence of alcohol subject you to a high risk of suffering from accidents. To avoid that you should consider avoiding alcohol when driving.

Helmets: If you are riding a bicycle, you should consider wearing a helmet. It is even advisable to wear a helmet even when riding a bike, skateboard, snowmobile or all-terrain vehicle.

Ways to Prevent Falls

Have hand rails in bathrooms

Keep nonslip mat in the shower

Hand rails on both sides of staircases

Remove area rugs

Have good lighting in the home

Keep stairs and floors clutter free

Check your vision regularly

Exercise on a regular basis

Ways to Prevent Head Injuries in Children

• Use safety gates at stairway top
• Clutter free stairs
• Install window guards
• Playgrounds with shock-absorbing materials
• Area rugs must be secure

Diagnosis of Traumatic Brain Injury

As traumatic brain injuries are often emergency cases, delaying treatment can only worsen its consequences. This is why doctors assess the situation very speedily so that the treatment can be initiated without much delay.

The assessment steps involve:

Glasgow Coma Scale

It is a 15-point test that assists the doctor in assessing the primary asperity of brain injury. It is done by checking your ability in the following directions and moving your eyes and limbs.

The abilities are rated from three to 15 in the Glasgow Coma Scale; a higher score means the injuries are not severe.

Imaging tests

Apart from the above-mentioned test for assessing the traumatic brain injury, some imaging tests will also be conducted for better diagnosis of the case which will even help in planning the treatment mode and understand the severity of the problem.

Computerized tomography (CT) scan: This test is first performed in an emergency room in case of suspected traumatic brain injury. It makes use of X-rays for getting a detailed view of your brain. A CT scan can swiftly visualize fractures and reveal the deposition of bleeding in the brain (hemorrhage), bruised brain tissue (contusions), blood clots (hematomas) and brain tissue swelling.

Magnetic resonance imaging (MRI): An MRI makes use of strong radio waves and magnets to create a detailed view of your brain. This test is used once your condition stabilizes, or in case the symptoms fail to improve, post injury.

Intracranial pressure monitor: Tissue swelling due to traumatic brain injury tends to increase the pressure within your skull which leads to additional damage to the brain. A probe is inserted through the skull for monitoring the pressure.

Treating Traumatic Brain Injury

If it is a mild injury, it may not need any treatment. You will mostly be advised to rest and take over-the-counter medicines for relieving the pain and headache. But you will be under constant monitoring, at home, to see if there are any new symptoms surfacing or if the medicine is able to cure the existing symptoms.

You will be advised by the doctor as to when you can resume your routine life like getting back to work, school or any recreational activity. For some time, you will be advised to limit your thinking and physical activities so that your body gets time to recover from the injury.

Immediate Emergency Care

An emergency care for mild to severe traumatic brain injuries majorly focuses on ensuring that the injured person has sufficient oxygen and blood supply. It even focuses on maintaining the blood pressure and preventing further damage to the neck or head.

In case of severe injuries to head, there can be other injuries also that will need attention. For treating such injuries, additional treatments given in the emergency room or in the ICU will include; minimized secondary damage owing to inflammation, bleeding or decreased supply of oxygen to the brain.

Medications for Traumatic Brain Injury

Diuretics: They decrease fluid amount in the tissues and increase your urine output. They can even help with reducing the pressure in the brain.

Anti-seizure drugs: You will be prescribed these drugs as traumatic brain injuries increase your risk of suffering from seizure.

Coma-inducing drugs: If there is a case of comatose brain, then you may be given drugs to enter into coma, as such conditions require the brain to get lesser oxygen to function properly.

Surgery for Traumatic Brain Injury

If there is an emergency situation or there is a need to minimize the additional damage bound to occur to the brain tissues, the doctor can recommend a surgery. It can help in addressing the below mentioned problems:

Removing clotted blood (hematomas): Collection of clotted blood, known as hematoma can occur due to bleeding, outside or inside the brain, which can put pressure on the brain tissue and damage it.

Skull fractures repair: A surgery can even be required for repairing severe skull fractures or for removing the pieces of skull in the brain.

Bleeding in the brain: Head injuries that lead to bleeding in the brain will require a surgery so as to stop the bleeding.

Rehabilitation for Traumatic Brain Injury

If you have suffered a major brain injury, you will be in need of rehabilitation. You may need to relearn the basic skills like walking and talking. The activities as done in the rehab centers focus on improving your ability to perform the daily activities.

These therapies normally happen in the hospital but can later be continued at inpatient rehabilitation units or residents. Depending on the brain part that has been injured and the severity of injury, the type as well as duration of rehabilitation will vary.

Conclusion

A traumatic brain injury has the potential of causing prolonged disability or death. Depending on the nature of the injury, it is a dire need to have the proper equipment and medical facility because that’s the only way to restrict damage and save a life.

The initial assessment stands to be the most crucial aspect of head injury ( traumatic brain injury treatment ) as it helps in determining the ideal treatment plan by assessing the injury extend and area of brain damage. In case of such traumatic injuries, every second is crucial in saving the life at risk.

We at Shalby Hospitals, Ahmedabad, understand how important the initial assessment and proper treatment plan is. This is why, our specialized trauma unit is well-equipped with the needed equipment range and expert team of doctors, surgeons, nurses and paramedical staff, who are trained in handling the trauma cases efficiently,. Our team of experts offer high-end medical and surgical care to the patients who suffer from traumatic brain injury. Our team works with the objective of minimizing any further damage and saving the precious lives.