Traumatic Brain Injury

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Introduction

What is traumatic brain injury?

Traumatic brain injury is a serious condition in which the brain is damaged by a sudden injury. There are many causes of traumatic brain injuries, including traffic or sport accidents, falls, or assault.

Traumatic brain injuries can occur with or without fracture of the skull. Skull fractures include open and closed fractures. Open fractures occur when the skin has been breached and the skull is broken. In closed brain fractures, the skin is not broken but the underlying skull is broken.

The brain may be pierced by an object, which may be embedded in or pass through the skull. In some cases of traumatic brain injury there may be no outer signs of damage, even though the brain itself may be bruised, swollen or bleeding. All types of traumatic brain injuries may be life threatening and cause permanent damage.

Treatment will vary substantially depending on the severity and cause of the traumatic brain injury. Surgery may be required to stabilize the injury. Head trauma should always be considered an emergency. Fortunately, you can help to avoid many traumatic brain injuries by proper use of safety equipment, such as a helmets and seatbelts, for your family and yourself.

Traumatic brain injuries may be life threatening. It is important to monitor for severe or changing symptoms. Seek immediate medical care (call 911) if you, or someone you are with, have a head injury and are experiencing serious symptoms such changes in consciousness, vomiting, severe headache, abnormal behavior, and dilated or unresponsive pupils.

Seek prompt medical care if you are being treated for traumatic brain injury but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of traumatic brain injury?

Symptoms of traumatic brain injury range from mild to severe. If any severe symptoms are observed, seek immediate medical care. Also seek immediate medical care if new symptoms appear or existing symptoms worsen.

Common symptoms of traumatic brain injury

You may experience traumatic brain injury symptoms daily or just once in a while. At times any of these traumatic brain injury symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, a traumatic brain injury can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Abnormal pupil size or nonreactivity to light

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Droopy eyelid

  • Garbled or slurred speech or inability to speak

  • Loss of muscle coordination

  • Paralysis or inability to move a body part

  • Seizures

  • Severe headache

  • Sudden change in vision, loss of vision, or eye pain

  • Vomiting

Causes

What causes traumatic brain injury?

There are numerous causes of traumatic brain injuries. The skull may or may not be fractured. Injuries may result from your head hitting an object, as in a fall, or an object hitting you, as with a gunshot wound.

In some traumatic brain injuries, the skull is not broken and there may be no outer signs of damage. This may occur if the object that hits your head, for example a baseball, does not penetrate the skull or if you are involved in a rapid deceleration, such as a sudden car crash. In a rapid deceleration, your brain may be injured as it slides forward and hits the front of your skull. This type of injury may cause bruising, swelling or bleeding of the brain.

What are the risk factors for traumatic brain injury?

A number of factors increase the risk of developing traumatic brain injury. Not all people with risk factors will get traumatic brain injury. Risk factors for traumatic brain injury include:

  • Failure to use appropriate safety equipment such as helmets

  • Failure to wear seat belts in moving vehicles

  • High-risk behaviors and activities, such as drinking and driving

  • Young age

Reducing your risk of traumatic brain injury

You may be able to lower your risk of traumatic brain injury by:

  • Avoiding high-risk behaviors and activities

  • Wearing a helmet when appropriate (for example, when riding a bicycle or motorcycle, playing football, or doing construction work)

  • Wearing a seatbelt while driving

Treatments

How is traumatic brain injury treated?

Most traumatic brain injuries require immediate medical attention. Because traumatic brain injuries can be life threatening, treatment of traumatic brain injuries aims to stabilize the injury and prevent further damage.

Treatment will vary substantially depending on the severity and cause of the traumatic brain injury. Surgery may be required to relieve pressure on the brain from bleeding inside the skull, to repair the broken skull, or to remove objects that have penetrated the brain. For mild brain injuries, careful monitoring for a few days after the injury is required to watch for the possible development of complications.

Damage caused by traumatic brain injuries may be permanent. A rehabilitation program may be recommended by your heath care provider to help you manage symptoms and cope with the resulting damage.

What are the potential complications of traumatic brain injury?

Complications of traumatic brain injury can be serious, even life threatening in some cases. It is essential to seek immediate treatment for head injuries. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of traumatic brain injury include:

  • Brain damage

  • Cognitive decline

  • Delayed hydrocephalus

  • Diminished quality of life

  • Disability

  • Emotional disturbances

  • Impaired balance and coordination

  • Incontinence

  • Increased risk of Alzheimer’s Disease

  • Loss of vision and blindness

  • Neurological problems, such as memory loss, confusion, and encephalitis

  • Paralysis

  • Permanent hearing loss

  • Permanent loss of sensation

  • Seizures

  • Unconsciousness and coma

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. NINDS traumatic brain injury information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tbi/tbi.htm.
  2. Head injury – first aid. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000028.htm
  3. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
  4. Maas AI, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol 2008; 7:728.
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