Traumatic Brain Injury

What is traumatic brain injury (TBI)?

Traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. It may happen when there is a blow, bump, or jolt to the head. This is a closed head injury. A TBI can also happen when an object penetrates the skull. This is a penetrating injury.

Symptoms of a TBI can be mild, moderate, or severe. Concussions are a type of mild TBI. The effects of a concussion can sometimes be serious, but most people completely recover in time. More severe TBI can lead to serious physical and psychological symptoms, coma, and even death.What causes traumatic brain injury (TBI)?

The main causes of TBI depend on the type of head injury:

  • Some of the common causes of a closed head injury include
    • Falls. This is the most common cause in adults age 65 and older.
    • Motor vehicle crashes. This is the most common cause in young adults.
    • Sports injuries
    • Being struck by an object
    • Child abuse. This is the most common cause in children under age 4.
    • Blast injuries due to explosions
  • Some of the common causes of a penetrating injury include
    • Being hit by a bullet or shrapnel
    • Being hit by a weapon such as a hammer, knife, or baseball bat
    • A head injury that causes a bone fragment to penetrate the skull

Some accidents such as explosions, natural disasters, or other extreme events can cause both closed and penetrating TBI in the same person.Who is at risk for traumatic brain injury (TBI)?

Certain groups are at higher risk of TBI:

  • Men are more likely to get a TBI than women. They are also more likely to have serious TBI.
  • Adults aged 65 and older are at the greatest risk for being hospitalized and dying from a TBI

What are the symptoms of traumatic brain injury (TBI)?

The symptoms of TBI depend on the type of injury and how serious the brain damage is.

The symptoms of mild TBI can include

  • A brief loss of consciousness in some cases. However, many people with mild TBI remain conscious after the injury.
  • Headache
  • Confusion
  • Lightheadedness
  • Dizziness
  • Blurred vision or tired eyes
  • Ringing in the ears
  • Bad taste in the mouth
  • Fatigue or lethargy
  • A change in sleep patterns
  • Behavioral or mood changes
  • Trouble with memory, concentration, attention, or thinking

If you have a moderate or severe TBI, you may have those same symptoms. You may also have other symptoms such as

  • A headache that gets worse or does not go away
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Not being able to wake up from sleep
  • Larger than normal pupil (dark center) of one or both eyes. This is called dilation of the pupil.
  • Slurred speech
  • Weakness or numbness in the arms and legs
  • Loss of coordination
  • Increased confusion, restlessness, or agitation

How is traumatic brain injury (TBI) diagnosed?

If you have a head injury or other trauma that may have caused a TBI, you need to get medical care as soon as possible. To make a diagnosis, your health care provider

  • Will ask about your symptoms and the details of your injury
  • Will do a neurologic exam
  • May do imaging tests, such as a CT scan or MRI
  • May use a tool such as the Glasgow coma scale to determine how severe the TBI is. This scale measures your ability to open your eyes, speak, and move.
  • May do neuropsychological tests to check how your brain is functioning

What are the treatments for traumatic brain injury (TBI)?

The treatments for TBI depend on many factors, including the size, severity, and location of the brain injury.

For mild TBI, the main treatment is rest. If you have a headache, you can try taking over-the-counter pain relievers. It is important to follow your health care provider’s instructions for complete rest and a gradual return to your normal activities. If you start doing too much too soon, it may take longer to recover. Contact your provider if your symptoms are not getting better or if you have new symptoms.

For moderate to severe TBI, the first thing health care providers will do is stabilize you to prevent further injury. They will manage your blood pressure, check the pressure inside your skull, and make sure that there is enough blood and oxygen getting to your brain.

Once you are stable, the treatments may include

  • Surgery to reduce additional damage to your brain, for example to
    • Remove hematomas (clotted blood)
    • Get rid of damaged or dead brain tissue
    • Repair skull fractures
    • Relieve pressure in the skull
  • Medicines to treat the symptoms of TBI and to lower some of the risks associated with it, such as
    • Anti-anxiety medication to lessen feelings of nervousness and fear
    • Anticoagulants to prevent blood clots
    • Anticonvulsants to prevent seizures
    • Antidepressants to treat symptoms of depression and mood instability
    • Muscle relaxants to reduce muscle spasms
    • Stimulants to increase alertness and attention
  • Rehabilitation therapies, which can include therapies for physical, emotional, and cognitive difficulties:
    • Physical therapy, to build physical strength, coordination, and flexibility
    • Occupational therapy, to help you learn or relearn how to perform daily tasks, such as getting dressed, cooking, and bathing
    • Speech therapy, to help you to with speech and other communication skills and treat swallowing disorders
    • Psychological counseling, to help you learn coping skills, work on relationships, and improve your emotional well-being
    • Vocational counseling, which focuses on your ability to return to work and deal with workplace challenges
    • Cognitive therapy, to improve your memory, attention, perception, learning, planning, and judgment

Some people with TBI may have permanent disabilities. A TBI can also put you at risk for other health problems such as anxiety, depression, and post-traumatic stress disorder. Treating these problems can improve your quality of life.Can traumatic brain injury (TBI) be prevented?

There are steps you can take to prevent head injuries and TBIs:

  • Always wear your seatbelt and use car seats and booster seats for children
  • Never drive under the influence of drugs or alcohol
  • Wear a properly fitting helmet when riding a bicycle, skateboarding, and playing sports like hockey and football
  • Prevent falls by
    • Making your house safer. For example, you can install railings on the stairs and grab bars in the tub, get rid of tripping hazards, and use window guards and stair safety gates for young children.
    • Improving your balance and strength with regular physical activity

Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Types of arm injuries include

  • Tendinitis and bursitis
  • Sprains
  • Dislocations
  • Fractures (broken bones)
  • Nerve problems
  • Osteoarthritis

You may also have problems or injure specific parts of your arm, such as your hand, wrist, elbow, or shoulder.

Chronic Kidney Disease

You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body’s chemicals balanced, help control blood pressure, and make hormones.

Chronic kidney disease (CKD) means that your kidneys are damaged and can’t filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.

The kidney damage occurs slowly over many years. Many people don’t have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.

Treatments cannot cure kidney disease, but they may slow kidney disease. They include medicines to lower blood pressure, control blood sugar, and lower cholesterol. CKD may still get worse over time. Sometimes it can lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplantation.

You can take steps to keep your kidneys healthier longer:

  • Choose foods with less salt (sodium)
  • Control your blood pressure; your health care provider can tell you what your blood pressure should be
  • Keep your blood sugar in the target range, if you have diabetes
  • Limit the amount of alcohol you drink
  • Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
  • Lose weight if you are overweight
  • Be physically active
  • Don’t smoke

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

College Health

College life involves excitement, along with new challenges, risks, and responsibilities. You are meeting new people, learning new things, and making your own decisions. It can sometimes be stressful. You have to deal with pressures related to food, drink, appearance, drugs, and sexual activity.

There are steps you can take to stay healthy and safe while you’re in college:

  • Eat a balanced diet
  • Get enough sleep
  • Get regular physical activity
  • Maintain your health with checkups and vaccinations
  • If you decide to have sex, practice safe sex
  • Make smart choices about alcohol and drugs
  • Get help if you are stressed or depressed

Centers for Disease Control and Prevention

Concussion

A concussion is a type of brain injury. It involves a short loss of normal brain function. It happens when a hit to the head or body causes your head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in your brain. Sometimes it can also stretch and damage your brain cells.

Sometimes people call a concussion a “mild” brain injury. It is important to understand that while concussions may not be life-threatening, they can still be serious.

Concussions are a common type of sports injury. Other causes of concussions include blows to the head, bumping your head when you fall, being violently shaken, and car accidents.

Symptoms of a concussion may not start right away; they may start days or weeks after the injury. Symptoms may include a headache or neck pain. You may also have nausea, ringing in your ears, dizziness, or tiredness. You may feel dazed or not your normal self for several days or weeks after the injury. Consult your health care professional if any of your symptoms get worse, or if you have more serious symptoms such as

  • Convulsions or seizures
  • Drowsiness or inability to wake up
  • A headache that gets worse and does not go away
  • Weakness, numbness, or decreased coordination
  • Repeated vomiting or nausea
  • Confusion
  • Slurred speech
  • Loss of consciousness

To diagnose a concussion, your health care provider will do a physical exam and will ask about your injury. You will most likely have a neurological exam, which checks your vision, balance, coordination, and reflexes. Your health care provider may also evaluate your memory and thinking. In some cases, you may also have a scan of the brain, such as a CT scan or an MRI. A scan can check for bleeding or inflammation in the brain, as well as a skull fracture (break in the skull).

Most people recover fully after a concussion, but it can take some time. Rest is very important after a concussion because it helps the brain to heal. In the very beginning, you may need to limit physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games. Doing these may cause concussion symptoms (such as headache or tiredness) to come back or get worse. Then when your health care provider says that it is ok, you can start to return to your normal activities slowly.

Centers for Disease Control and Prevention

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