Traumatic Brain Injuries – Signs, Symptoms, and Causes
If your child has ever fallen beside a pool or you have been hit on the head during a car accident, your immediate thought may not have been about the possibility of a brain injury or long-lasting consequences. Instead, you may have shrugged the incident off, assuming that some over-the-counter pain relievers and a bit of rest would solve all your problems.
However, traumatic brain injuries can be caused by nearly any type of blow to the head, and symptoms can range from mild to severe. Without prompt medical care, you or your loved one could face long-lasting disabilities or even death. To prevent these frightening consequences, be sure that you know just what a traumatic brain injury is, how you can prevent one, and how you should react if or a loved one has a head injury.
What Is Traumatic Brain Injury?
A traumatic brain injury is an injury to the soft brain tissues that occurs from a violent blow, an unexpected jolt, or a penetrating injury. For example, a bullet could cause this type of injury as could your own skull bone if it is shattered. However, much more innocuous events could also cause traumatic brain injuries or TBIs. No matter how the injury happens, bleeding or bruising in the brain tissues can cause short-term or long-term damage to the brain, which could result in physical and mental side effects.
Even if you have never known someone who has sustained a traumatic brain injury, they are quite common. Approximately 1.7 million cases of TBI occur across the country every year. For up to 90,000 of these people, TBI leads to long-lasting disabilities.
Risk Factors and Causes of Traumatic Brain Injury
Children and teenagers are at high risk for traumatic brain injury because they often overestimate their own safety or are involved in high-risk activities. In particular, children younger than 4 years of age and young adults between the ages of 18 and 24 are at heightened risk. In addition, seniors are at high risk because they may not have the best balance and are at risk for falls. Finally, males are at far higher risk than females when it comes to TBI with well over 70 percent of cases happening to this demographic.
Approximately 50 to 70 percent of traumatic brain injuries can be traced back to motor vehicle accidents. Another 20 percent can be traced back to sports and recreational injuries, especially among young adults and young children. Other top causes of TBI include the following:
- Falls
- Violence, including domestic violence, child abuse, shaken baby syndrome, and gunshot wounds
- Combat injuries and explosions
- Blunt force
Signs and Symptoms of Traumatic Brain Injury
For some people, signs and symptoms of traumatic brain injury are incredibly obvious and occur immediately. Others with mild TBI may not see any signs and symptoms for up to a couple of days following the injury. Signs and symptoms range from mild to severe with many people having at least some of the following symptoms.
- Tiredness
- Headache
- Confusion
- Mood changes
- Problems with memory or thinking
- Blurry vision
- Ringing of the ears
- Dizziness
- Sleep changes
- Sensitivity to lights and sounds
Many people with mild injuries do not lose consciousness at all. Others lose consciousness for a few minutes or longer. Those who have more severe brain injuries may see the previously listed symptoms along with some or all of the following:
- Prolonged loss of consciousness
- Worsening headache
- Seizures
- Vision changes
- Numbness in the extremities
- Changes in coordination
- Problems waking up
- Combativeness
Children may not display the same symptoms that adults do, but you may notice that a child is more irritable than usual, cannot be consoled when crying, has changed in eating or sleeping patterns, or seems uninterested in favorite activities. It is important that you seek prompt medical care for any of the above symptoms if you or a loved one has recently had any kind of bump, jolt, or blow to the head.
Diagnosing Traumatic Brain Injuries
Traumatic brain injury diagnosis must occur rapidly to decrease the possibility of more distressing symptoms in the future and to limit the extent of brain damage to prevent lifelong disabilities. If the patient is conscious, the doctor will do a quick examination of physical reflexes, strength, and mental acuity. The doctor will also use the Glasgow Coma Scale, which is a 15-point scale used to determine basic brain function and to check brainstem reflexes. Of course, the doctor will also collect information about the injury and how it occurred. If you are in the emergency room with a person who has sustained an injury, you may be asked about whether or not the person was unconscious, if you observed any changes in the person’s speech and what other information you have about how the injury was sustained.
In addition to these hands-on tests, examinations, and interviews, the doctor will most likely also order some imaging tests to determine if there is any acute damage. A CT or computerized tomography test is often ordered first because it can be completed quickly and provides an excellent overall picture of the brain. It will show any bleeding, brain swelling, and blood clots. If the CT scan reveals potential problems, a more in-depth MRI or magnetic resonance imaging test may also be ordered. This test may also be used after the patient begins to stabilize or for diagnosing ongoing problems if the patient is not responding to treatment.
Possible Complications
Certain complications may occur shortly after the injury although some may not occur for several days. One of the most concerning complications is a coma, which is unconsciousness along with an inability to respond to any type of stimulus. In some cases, coma may lead to a vegetative state or death. Other possible complications that can be more easily addressed include the following:
- Vertigo
- Seizures
- Hydrocephalus, or fluid on the brain
- Brain infections from penetrating injuries
- Cranial nerve damage leading to changes in feeling, vision, taste or smell
- Chronic cognitive changes
- Chronic behavioral changes
Some researchers also believe that severe TBI could lead to such degenerative brain diseases as Alzheimer’s disease and Parkinson’s disease, although more research is needed in this area to draw definitive conclusions.
Traumatic Brain Injury Treatments
A mild TBI often does not need any treatment other than some simple pain relievers that you can get over the counter. You may also need to take a bit of time off work or school so that you can rest and get back to normal.
For those with moderate to severe injuries, emergency medical care is imperative for reducing pressure on the brain. Many individuals require oxygen, blood pressure support, and brain decompression following injury. Diuretics, which are fluid-reducing medications, may be able to help. The doctor may also prescribe anti-seizure medications. If the brain needs some time to rest, the doctor may prescribe medications to put the patient into a medically supervised coma, which can help the brain get more oxygen.
If there is a blood clot, bleeding in the brain, or a fractured skull, brain surgery may be necessary to reduce further damage or to remove broken bone fragments. In some cases, the surgeon may open an area of the skull bone to reduce pressure and create a way to drain excess fluid from the brain.
Recovery and Rehabilitation
Those with moderate or severe injuries will probably need several weeks or longer to recuperate fully following a TBI. At first, they will recover somewhat in the hospital until their condition is stable and they no longer need many drugs for their blood pressure or other concerns. They may need to go to another nursing facility following this or may be discharged home.
Certain types of therapy are vital following severe TBIs to ensure that the individual recovers as much of his former abilities as possible. Physical therapy can help improve strength, balance, mobility, and coordination. Occupational therapy helps individuals perform activities of daily living, such as getting dressed and bathing, on their own. A rehabilitation nurse or caseworker may get involved to make sure that all facets of rehabilitation work together well.
The patient may need to see a variety of other professionals as well to ensure that he recovers fully in all areas. These could include visits to the following experts.
- Psychiatrist
- Vocational counselor
- Speech and language pathologist
- Social worker
- Recreational therapist
Some individuals with TBI or their family members may find that it helps to join a support group. Here, individuals will find other people who have gone through similar situations and may find that they feel less overwhelmed by the recovery process.
Of course, there are many ways that you can prevent a traumatic brain injury from happening in the first place. By being careful when driving, teaching your children how to engage in sports safely, and looking after the older adults in your life, you can be a positive role model for safety inside and outside the home.