A traumatic brain injury is among the possible results of getting injured in an accident. Traumatic brain injuries are caused by forceful bumps, blows, or jolts to the head or body or by objects that penetrate the skull into the brain. However, head injuries do not always cause a TBI.
There are various classifications of TBI, depending on the severity of the injury. In most cases, a 3 to 8 GCS score means severe traumatic brain injury. Generally, the more severe the injury, the longer it will take for you to recover. Still, there is always a possibility of recovery, even in severe cases.
Traumatic brain injuries (TBIs) may occur as a result of a bump on the head or from blunt or penetrating trauma. An impact causes the brain to crash back and forth within the skull, bruising, bleeding, and shearing of nerve fibers.
It is common for the brain to swell after the initial trauma. Eventually, this leads to further bleeding and reduced blood flow in the brain.
In the absence of treatment, brain swelling can lead to nutrient and oxygen deprivation, resulting in the death of brain cells. This cell death usually causes TBI symptoms.
A traumatic brain injury can be classified into four main types based on its severity. The Glasgow Coma Scale (GCS) is a tool used to assess the severity of a TBI by an individual’s level of consciousness following it.
There are 15 points in the GCS. Points are awarded based on various functions, such as eye-openings and verbal responses. Higher scores indicate higher levels of function, indicative of less severe injuries. There are four severity levels:
A traumatic brain injury can be classified into two major categories: closed and open (or penetrating). A closed injury is a TBI that does not fracture the skull. On the other hand, open injuries occur when the skull bone breaks or is penetrated, exposing the brain to the elements.
A traumatic brain injury can occur within either of these two groups in a variety of different ways:
Most brain injuries occur as a result of concussions. If a strong force strikes you, your brain will move toward that force until it collides with your skull, causing damage.
Concussions were often considered minor inconveniences in the past, but doctors now take them very seriously. Symptoms range from mild to severe, sometimes lasting a lifetime. If you experience concussion symptoms for more than a month following a concussion, then you are most likely suffering from post-concussion syndrome.
Concussions often accompany these symptoms. Contusions are essentially bruises on the brain, a mild form of bleeding. One type of contusion involves two parts of the brain being injured simultaneously.
If a contusion does not heal independently, it can become a hematoma. Doctors must perform surgery to remove a hematoma. Contusions cause different types of damage depending on their size, location, and duration.
The term hematoma refers to the collection of blood outside of blood vessels. Leaving large hematomas in the brain untreated can result in severe injury or even death. Hematomas of the brain can be classified into several types, including:
It is common for hematomas to develop several days or weeks after a head injury. Hematomas cause vomiting, severe headaches, unequal pupil sizes, and slurred speech. Call your physician immediately if you experience any of these symptoms after your brain injury.
Uncontrolled bleeding in brain tissue or on the surface of the brain is called a brain hemorrhage. An intracerebral hemorrhage originates in the cerebral matter, while hemorrhages in the subarachnoid space are called subarachnoid hemorrhages.
The hemorrhaging of the brain is one type of focal traumatic brain injury. A focal brain injury affects only one part of the brain. If not treated promptly, these injuries can still be life-threatening despite causing less severe damage than other types of TBI.
A coup-contrecoup injury is another type of severe traumatic brain injury. As coup and contrecoup are French words meaning “blow” and “counterblow,” coup-contrecoup injuries are two different injuries:
People who suffer coup-contrecoup injuries usually hit their heads against stationary objects, like steering wheels. A skull hit by an object causes the brain to move forward until it collides with the front of the skull. As a result of the impact, the brain rebounds off the front of the skull and strikes the back, which causes a second impact.
These injuries are caused by objects penetrating the skull and brain, most commonly bullets. The risk of developing epilepsy after a traumatic brain injury is higher in people with penetrating head wounds. Objects lodged in someone’s skull should never be removed without a doctor’s approval. This could worsen the bleeding and lead to further damage.
One of the most severe types of TBI is diffuse axonal injury. When the brain is shaken or twisted in the skull, these injuries occur. The cerebral tissue slides back and forth during a twisting movement, tearing the long fibers connecting the brain cells (called axons). This is known as axonal shearing. Axonal shearing disrupts the messages neurons send, causing neurons to lose function.
A diffuse axonal injury is difficult to detect on an MRI because it results in only microscopic tears. The size and location of the tears affect the severity of diffuse axonal damage.
Recurrent traumatic brain injury occurs when you suffer a second head injury soon after sustaining your first. The second injury usually causes more serious damage and has more severe consequences for a victim’s health. Even if you do not lose consciousness or still feel fine after a blow to the head, go straight to the hospital.
The treatment for TBI depends on the type and severity of the injury. Your doctor would send you home to rest if the injury only caused mild bruises. Several days after a surgery, you should be able to resume your normal activities.
Treating a more severe injury may require more time and effort, but recovery is still possible. To regain function, your therapy will primarily activate your brain’s neuroplasticity. Through neuroplasticity, undamaged areas of the brain can replace damaged ones. Speech therapy, cognitive training, and physical and occupational therapy are some techniques doctors use to activate neuroplasticity.
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