A traumatic brain injury (TBI) is defined as a blow to the head or a penetrating head injury that disrupts the normal function of the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
Symptoms
Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of damage to the brain. Mild cases may result in temporary confusion or a headache, while severe cases may result in extended periods of unconsciousness, coma, or even death.
To be safe, people should always get checked by a doctor after a blow to the head. Seek emergency help if symptoms include convulsions, weakness or numbness in the extremities, repeated vomiting or slurred speech. Because the consequences of brain injury can worsen swiftly without treatment, doctors usually need to assess the situation rapidly.
Diagnostic tests
Initial tests to determine the severity of injury may include the Glasgow Coma Scale, a test to assess the central nervous system, and CT (computed axial tomography) scan and MRI (magnetic resonance imaging). Injured brain tissue often swells, increasing the pressure inside the skull. Doctors may insert a probe to monitor intracranial pressure and drain excess fluid.
Treatment
Emergency care focuses on preventing brain injury from getting any worse. Medical and surgical advances have improved the odds for surviving a TBI. Medications such as diuretics can reduce the amount of fluid in tissues. The goal of all surgical treatment is to prevent secondary injury by helping to maintain blood flow and oxygen to the brain and minimize swelling and pressure.
Surgical options include:Removing clotted blood – Surgeons can remove large deposits of clotted blood trapped between the skull and the brain, reducing the pressure inside the skull and helping to prevent additional brain damage. Bleeding vessels or tissues may need to be repaired.
Repairing skull fractures - Many skull fractures heal on their own. When a portion of the skull is pressing into the brain, repair is needed. Damaged tissue may need to be removed.
Creating a window in the skull - If the pressure inside the skull cannot be controlled by any other means, surgeons may opt to create an opening in the skull and leave it open until the swelling subsides (usually a few days).
Patients recovering from traumatic brain injury at the SSM Neurosciences Institute are admitted to a specialized Neuro Intensive Care Unit or step-down unit designed exclusively for the care of neurological patients. SSM Rehab works with families to create a post-hospital care plan for patients.