A brain injury can occur whenever there’s a sudden trauma to the head. This can involve the penetration of an object, a violent impact, or even just a strong shaking, such as may occur during the rapid deceleration of a road traffic accident.
Brain injuries are classified as mild, moderate, or severe, depending on the symptoms and the extent of the damage. Unfortunately, there are no treatments available for the damage caused by the initial brain injury. However, in many cases, it’s the secondary damage caused after the initial injury that’s of most concern, and this is the focus of treatment for victims of Traumatic Brain Injuries (TBI).
As discussed above, prompt treatment is essential for TBI victims if further damage is to be avoided, therefore it’s vital to know the signs of a moderate or severe brain injury. If the victim shows any of the following symptoms they should seek urgent medical treatment as soon as possible:
- A persistent headache that gets steadily worse
- Repeated vomiting or nausea
- Convulsions or seizures
- Difficulty waking
- Dilated pupils
- Slurred speech
- Disorientation, confusion, or loss of coordination
This article on brain injury is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
Stabilisation of injured patient
Since nothing can be done to treat the damage that’s already been caused, the primary concern of the medical staff treating brain injury will be to stabilise the patient to prevent any further damage. This can be caused by insufficient oxygen to the brain, high blood pressure, high inter-cranial pressure, or infection from foreign bodies.
Most brain injury patients will be intubated (a tube placed into the trachea) to ensure a constant and consistent supply of oxygen to the brain. This is vital as oxygen deprivation can have a devastating effect on brain tissue. The patient will also be given intravenous fluids to maintain a normal blood pressure ensuring that oxygen reaches the brain efficiently.
Another danger at this stage is seizures which can cause extensive damage. These are often controlled with drugs such as benzodiazepines. Body temperature is also carefully controlled to protect the brain tissue.
Investigation to extent of brain injury
Once the patient has been stabilised, the medical team will undertake a series of investigations to assess the extent of the damage caused by the brain injury. These can involve CT scans, MRI scans, X-rays, and exploratory surgery. Where there has been a penetration the neurosurgeons will often operate at this stage to assess the damage.
Intra-cranial pressure may be monitored using either neuro-imaging techniques or by inserting a catheter directly into the skull. If excess pressure is found there are several methods of relieving it, depending on the type of injury. These include diuretics, intravenous hypertonic saline drips, sedatives, and analgesics.
Where contusions (bruised brain tissue), hematomas (ruptured blood vessels), clots, lesions, or other internal bleeding are found, it’s usually necessary to perform surgery to relieve the pressure these place on the brain.
In the short time after a brain injury, a decompressive craniectomy may be performed, in which a section of the skull is removed temporarily to relieve the pressure. If the skull has been fractured, a craniotomy may be required so that the fragmented area can be permanently removed.
Around two-thirds of people with moderate brain injury, and virtually all people whose injuries are classified as severe, will be left with some form of disability as a result of the damage to their brain. These range from speech and coordination problems to behavioural problems and mental health issues.
A comprehensive suite of rehabilitation services is available to help people recover as much function as possible after suffering brain injury and to help them to learn to cope with their disability. These include physiotherapists, speech therapists, psychologists, and psychiatrists. Numerous drugs are also available to manage the symptoms of brain injury, including anti-depressants, anti-epileptics, and sedatives.
In short, brain injury cannot be treated. Once the damage is done, it is usually irreversible. However, as we have seen above, there is a great deal that can be done following a TBI to prevent the initial damage from getting any worse. Prompt action by all concerned can make the difference between the victim dealing with a minor disability and having to come to terms with much worse.