By Adrian Sparrow
Traumatic Brain Injury: Symptoms, Treatment and Misinformation
A traumatic brain injury, or TBI, is a serious medical condition that results from trauma such as a sudden jolt or blow to the head or an object that goes through brain tissue, like a bullet or a shattered piece of skull. The extent of symptoms and recovery time varies depending on the scope of the damage. Some symptoms may show immediately, while others may take hours, days, or even weeks to appear.
Types and Causes
A traumatic brain injury can present itself in multiple ways, although they all stem from either a closed brain injury where the skull remains intact or a penetrating brain injury where there is a break in the skull.
Types of TBIs include Mild, Moderate, and Severe. Most TBIs are mild TBIs or concussions.
Causes can include car accidents, gunshot wounds, assault and abuse, sports injuries, explosions, and falls.
As the name implies, a traumatic brain injury is a traumatic event and requires medical care, especially if there are any signs of significant damage to the head or symptoms of a TBI.
People who experience a TBI may have several symptoms, depending on the extent and location of the injury.
Cognitive: A person may experience loss of consciousness, confusion, memory or concentration problems, mood swings, depression, anxiety, trouble sleeping or staying awake. A more severe injury might show profound confusion, unusual aggression or agitation, slurred speech, and more extended periods of unconsciousness or coma.
Physical: Headache, nausea or vomiting, fatigue, dizziness, and sensory problems are some of the symptoms present in mild TBIs. More severe injuries could result in seizures, dilated pupils, clear fluid draining from the nose or ears, weakness or numbness, and the inability to be woken from sleep.
Treatment and Complications
Treatment for a TBI depends on severity.
Mild injuries require rest, over-the-counter pain relievers, and close monitoring for new or worsening symptoms. Follow-up appointments with the doctor will indicate when the patient can return to normal activities, sometimes gradually.
More severe TBIs will require emergency care to prevent or minimize secondary damage, usually from pressure, swelling, or bleeding. Patients may need surgery to remove debris, pieces of the skull, or blood clots. Other surgeries stop bleeding or address swelling by opening a window in the skull. An injured brain is at risk of seizures in the week following the injury and may need anti-seizure drugs. In some cases where the brain can’t get enough blood flow or oxygen, doctors might use a medically-induced coma to protect from further damage. Following emergency care, people with significant brain injuries will often require rehabilitation.
Moderate and severe TBIs can result in prolonged and permanent conditions, including post-traumatic epilepsy, fluid in the brain (hydrocephalus), infections, blood vessel damage, headaches, and vertigo. Nerve damage from the injury can result in paralysis of facial muscles and changes or loss of smell, taste, vision, and hearing. Based on the location and extent of the injury, patients might need to relearn basic everyday skills like walking and talking or learn new coping strategies.
Long term, TBIs could increase the risk of degenerative brain diseases, including Alzheimer’s, Parkinson’s, and dementia pugilistica.
TV, films, and the internet are ripe for myths and misinformation. Unfortunately, in the case of TBIs, these myths can be deadly. Some myths include:
- If you don’t lose consciousness, you don’t have a concussion.
You don’t have to lose consciousness to have a brain injury.
- If you didn’t get hit on the head, you can’t have a brain injury.
Brain injuries can result from an intense shake or jolt to the head, including shaken baby syndrome.
- After two years, the brain can make no further recovery.
Recovery depends on the person and injury. Some symptoms may disappear within days; others might remain for life.
- Brain injuries can always be seen on an MRI or CT.
Not all brain injuries, especially mild ones, can be seen. These tests look for brain bleeds, skull fractures, and other acute trauma, but a clear scan doesn’t necessarily equal the absence of injury.