Causative & risk factors
Trauma to the brain can be caused due to an open or closed head injury. The common causes of TBI include falls, road accidents, bullet wounds or a direct hit to the head from any object.
Clinical presentation
Broadly, traumatic brain injury can be classified as concussion, contusion or hemorrhage. The effects of concussion and contusion are usually reversible, whereas brain hemorrhage can give rise to complications.
The extent of damage to the brain will determine the severity of the symptoms. The patient may lose his consciousness. Confusion and dizziness are commonly found symptoms after trauma to the brain. The patient may experience physical symptoms such as blurring of vision, ringing in the ears or a bad taste in the mouth. He/she may become lethargic, moody and experience a change in the sleep pattern. Severe TBI can produce problems with the memory, thinking, behavior or concentration. The patient may complain of a persistent headache, along with nausea and vomiting. Sometimes the patient may land into convulsions or seizures. The skull may be fractured or the patient may land into a stroke.
Severe TBI symptoms can include excessive drowsiness, in-coordination, slurring of speech, dilatation of the pupils, confusion and agitation. The patient may sometimes land into a coma or even die as a result of TBI.
Investigations
Imaging tests such as X-rays, CT or MRI scans of the brain are performed. The intracranial pressure must be measured through a probe inserted into the skull. The patient is assessed on the basis of the ‘Glasgow coma scale’ to know the severity of his condition.
Treatment
All patients with traumatic brain injury need immediate medical attention. Patients with mild TBI only need to be monitored. Steps are taken to stabilize the patient. Even though the brain damage already caused is irreversible, measures can be taken to prevent further damage. The patient’s vital signs are monitored and measures taken to normalize them. Ventilatory support is given.
Certain medications may be necessary such as diuretics, analgesics and anti-seizure drugs. Medications are given to reduce brain oedema. Surgical procedures such as craniotomy are necessary to treat skull fractures and hematomas.
The symptoms developed by the patient need to be managed with a team of experts including a psychiatrist, a speech therapist, an occupational therapist, a physical therapist etc.
