What is a traumatic brain injury?

A traumatic brain injury (TBI) can occur when there is a severe, violent strike to the head that causes the brain to bump against the inside of the skull. It can also occur when an object, such as a bullet or a piece of the skull, penetrates the brain.

Are traumatic brain injuries serious?

They can be. These types of injuries can cause bleeding or swelling of the brain, as well as damage to the nerve cells. This disrupts the way the brain sends messages out to the rest of the body. Traumatic brain injuries can affect behavior, speech, sensation and movement. However, many people recover from these types of injuries and have no lasting effects.

Types of head injuries

• A concussion is a jarring injury to the brain. Most of the time it doesn't involve a loss of consciousness. A person who has a concussion may feel dazed and may lose vision or balance for a while after the injury
  
• A brain contusion is a bruise of the brain. This means there is some bleeding in the brain, causing swelling.
• A skull fracture is when the skull cracks. Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury.
• An intracranial hematoma is bleeding anywhere inside the skull that collects and clots. A mass of clotted blood forms within brain tissue, or more often in between the brain and the skull. An intracranial hematoma may not be apparent for a day or even as long as several weeks. It's important to tell your doctor if someone with a head injury feels or acts strangely. Watch out for headaches, listlessness, balance problems or throwing up.
• A scalp or facial hematoma is bleeding outside the skull that collects and clots, often forming a firm lump on the scalp or forehead. A black eye is another type of hematoma that forms when there is bleeding under the skin around the eye. While these hematomas can look bad, they usually heal without any permanent damage.

What are the symptoms of a traumatic brain injury?

Symptoms of a mild traumatic brain injury include:

• Loss of consciousness
• Headache
• Confusion
• Feeling dizzy or lightheaded
• Blurry vision
• Ringing in the ears
• Feeling tired
• Changes in mood
• Trouble thinking, concentrating or remembering

Symptoms of a moderate or severe traumatic brain injury include all of the symptoms listed above as well as:

• Vomiting or nausea that doesn’t stop
• Seizures
• A headache that won’t go away
• Unable to wake up after sleeping
• Dilated pupils (pupils that are larger than normal) or pupils of different sizes
• Trouble walking or speaking
• Drainage of bloody or clear fluids from ears or nose
• Slurred speech
• Changes in behavior, such as irritability or confusion
• Weakness or numbness in the arms or legs

Always seek medical attention if you have hit your head. If you experience any of the symptoms of a moderate or severe traumatic brain injury, call 911 or go to the nearest emergency room for treatment.

 What happens after a traumatic brain injury?

If you have a mild traumatic brain injury, it's normal to feel dizzy, have a headache or feel nauseous. Other symptoms include ringing in the ears, neck pain, and feeling anxious, upset, irritable, depressed or tired. These symptoms usually go away after a few days to a few weeks.

If you have a moderate or severe traumatic brain injury, you may have lasting problems with thinking, concentrating or paying attention. Short-term memory may also be affected. There may be changes to your personality and you may feel anxious, upset, irritable or depressed. You may have trouble controlling your impulses.

In some cases, a severe traumatic brain injury can lead to coma or death.

How is a traumatic brain injury diagnosed?

At the hospital, the doctor will perform a neurological test. You’ll be asked to answer some questions, follow some instructions and move your arms and legs. This test can help the doctor determine how severe your brain injury is. You may also have other tests, such as a computerized tomography (CT) or magnetic resonance imaging (MRI). These tests take pictures of your head and brain. They help your doctor see if there is a fracture of the skull or bleeding, bruising or blood clots in the brain.

How is a traumatic brain injury treated?

Treatment for a traumatic brain injury depends on the severity of the injury. If you have a mild traumatic brain injury, over-the-counter pain medicine can help with headaches and neck pain.

Treatment for a moderate or severe traumatic brain injury depends on the symptom. If you are having seizures, you may be given medicine to reduce the number of seizures. If you have certain kinds of arm spasticity, you may be able to try an injection of botulinum toxin into the muscle to help stop muscle spasms. You may need surgery if there is a skull fracture, if there are blood clots that need to be removed from the brain or if there is too much pressure inside the skull.

If the traumatic brain injury is severe, you may need physical and occupational therapy to regain skills that you may have “forgotten” because of your brain injury. Some of these skills can include walking, talking and feeding yourself.

Physical therapy is made up of stretching, strengthening exercises and muscle training. It helps with flexibility, coordination and strength.

Occupational therapy can help you re-learn how to perform daily tasks, such as bathing, getting dressed, cooking and writing. An occupational therapist can also teach you more about your injury and how to deal with it.

• Does a traumatic brain injury cause permanent brain damage?
• How can a traumatic brain injury be prevented?
• How long will it take me to recover from a traumatic brain injury?
• Could I have a traumatic brain injury and not know it?
• How can physical and occupational therapy help me?
• Are there support groups for people with traumatic brain injuries?