A traumatic brain injury (TBI) can dramatically change your life. It can affect your ability to think and learn, your emotions and feelings, and how well you can do daily activities.
The physical consequences of a TBI depend on what areas of the brain are injured. But most people who have a TBI will experience some weakness on one side of their body or increased clumsiness.
Traumatic Brain Injuries
Traumatic brain injuries (TBI) can occur in any number of ways – from the head being struck by an object, to car accidents or work-related injuries. They are a leading cause of emergency department visits, hospitalizations and deaths. The impact of TBIs on individuals varies greatly, from a simple headache to permanent physical and cognitive disability.
The most serious TBIs can lead to life-threatening blood clots, permanent disability and death. The damage to the brain from a TBI can affect every aspect of an individual’s life, including their quality of sleep, mood and ability to think clearly. It can also have a significant effect on a person’s financial stability, as TBI patients can often lose their jobs and struggle to maintain an income due to the limitations of their injury.
In the past, the idea was that severe TBIs were sudden, brutal events with harsh, long-lasting consequences, but research now shows that chronic outcomes are common even in a proportion of cases previously classified as mild. These chronic consequences carry heavy burdens for patients, their families and society as a whole.
When a person suffers a TBI, the brain is forced to take detours in its efforts to deliver nutrients and oxygen where they are needed. These disruptions can cause a variety of symptoms, including a loss of memory and the inability to plan or solve problems. They can also make it difficult to interact socially and communicate, which can have lasting effects on relationships and self-esteem.
The damage from a TBI can vary by area of the brain. Some examples include contusions, which are bruise-like injuries caused by an impact to the brain and broken blood vessels; diffuse axonal injury, which is shearing and stretching of nerve cell axons at a cellular level; and closed head injury with penetration, in which skull fragments or objects (bullet) penetrate the skull and cause damage to the brain.
Researchers have a better understanding of the lasting effects of TBIs, and are investigating ways to promote the brain’s innate healing abilities, known as neuroplasticity. They are focusing on areas like white matter degradation, protein misfolding and persistent neuroinflammation that result from brain trauma.
Concussions
Getting hit in the head with enough force can cause the brain to rock back and forth or bang against the inside of the skull. This can cause bruising of the brain tissues and swelling, both of which can interfere with how the brain functions.
Symptoms can vary depending on the type of concussion and the person. They can include headaches, changes in vision or balance, memory loss and dizziness. In most cases, the symptoms will clear up within a few weeks, but they can also last longer. Repeated concussions are linked to long-lasting problems, such as chronic traumatic encephalopathy (CTE), which can lead to dementia and difficulty thinking, concentrating, remembering and naming things.
The skull is designed to prevent most injuries to the brain, but it can’t prevent all of them. In fact, the blow that causes a concussion can cause microscopic damage to brain cells without any structural damage showing up on a CT scan or X-ray. This can make the brain swell and compress blood vessels, which can cut off the flow of oxygen and glucose to the injured tissues.
It’s important to rest completely after a head injury and to avoid activities that require quick movements or that are physically demanding, because they can increase the risk for another concussion. In rare cases, a second concussion while the brain is still healing can lead to severe, life-threatening swelling known as second impact syndrome (SIS).
Sometimes a TBI can be associated with other injuries, such as facial fractures, limb lesions or amputations, spinal cord injury, ocular damage or pelvic fractures. These can be independent of the TBI or can occur in association with it, affecting quality of life.
The medical community divides TBIs into traumatic and non-traumatic acquired brain injuries. The former results from an outside force hitting the head, while the latter occurs as a result of something “going wrong” with the brain, such as a stroke or vascular problem. However, both types can have the same unpleasant and long-lasting effects. This is why it’s so important to take TBIs seriously, regardless of how they occur.
Secondary Injuries
A Traumatic Brain Injury can cause a variety of different symptoms. Some are immediate and can include unconsciousness, difficulty learning and remembering new information, depression, changes in vision and hearing and unsteadiness or loss of balance.
These symptoms are the result of the body’s natural response to brain trauma. These reactions can take the form of decreases in blood flow, edema, haemorrhage, seizures or ischemia. These reactions occur in the wake of a brain injury because they can block the delivery of fuel to injured areas, so other areas must take up more work and wear out faster.
When the toxins in the bloodstream start to build up, they produce free radicals that can damage the cells of the brain. This can result in a host of symptoms, including dementia, movement disorders and even Alzheimer’s disease years after the initial head trauma.
Some researchers have used the term “secondary injury” to refer to any type of complication that arises in the aftermath of an initial trauma to the brain. While some secondary injuries are associated with a particular TBI, the exact causes remain unclear. The most likely explanation is that an individual’s pre-existing conditions, like drug abuse or severe psychiatric problems, may interfere with the pure effects of a TBI.
A secondary injury may also develop because the brain does not shut off its natural reactions to a head trauma, and these responses can lead to further damage to the brain. For example, the influx of calcium ions that occurs in a TBI can trigger neurotransmitters to be released from one synapse and bind to receptors on neighboring neurons. This can cause an imbalance in the level of glutamate that reaches these receptors, which ultimately leads to ischemia and further injury (Guzman-Lenis et al. 2009).
A TBI can trigger a variety of other secondary injuries, such as problems with vision or hearing, unsteady gait or loss of balance, nausea and vomiting and persistent headaches. A TBI victim should seek medical attention if these symptoms persist, as they can indicate that the condition is progressing. An experienced lawyer can help a victim recover damages for the costs of future medical bills and latent losses that may include lost wages.
Treatment
A traumatic brain injury can occur from blunt trauma to the head, such as a car crash or fall, or from penetrating trauma (such as gunshots and stabbing). When the brain collides with the skull there is often bruising, bleeding, and tearing of nerve fibers. In some cases, the skull may be fractured. If a person has had a TBI, they may be confused or have blurry vision and dizziness. They may also lose consciousness.
TBI can lead to many different symptoms and problems, such as difficulty thinking, memory loss, seizures, changes in mood or behavior, and physical disabilities. Some people with mild TBIs have no problems and recover quickly. Others have more trouble and require longer recovery time. The severity of the injury and how well a person recovers depends on a number of factors, including how long they were unconscious, how severe their injury was, and whether there were any other health problems, such as a stroke, that also occurred with the TBI.
Research is ongoing to understand how TBIs cause these changes in the brain. One study found that a single TBI changes thousands of genes in the hippocampus, which is involved in learning and memory. Another recent study found that TBI can speed up the onset of cognitive impairment in older adults.
People who have a TBI should see their healthcare provider, even if they think the injury was not serious. They should get a medical exam, especially if they have symptoms like loss of consciousness or confusion that do not go away.
All people with a TBI should be evaluated by a healthcare provider who has experience in diagnosing and treating head injuries. The doctor will ask questions about how the injury happened and do a neurological examination to judge the level of consciousness, memory and thinking, hearing, touch, balance and strength and sensation, and gait and coordination. A specialized MRI or CT scan of the brain can also be used to help diagnose and treat brain injuries. In some cases, the doctor will recommend surgery to remove blood clots in the brain (hemorrhage) or to reduce pressure on the brain (edema). Other times, doctors prescribe medications and other treatments for a person with a TBI.