Traumatic Brain Injury – MemoryFAQs.com

Introduction

Head injuries are some of the most common physical traumas that lead to permanent disability or death. Traumatic brain injury (TBI) occurs due to a severe shaking or physical impact on the skull, scalp, brain, brain tissues, or any of the brain’s structures. These traumas obstruct the normal functions of the brain and endanger the affected individual’s life.

The injuries caused by a violent blow to the head, a sudden rough jolt, or any other head trauma that results in a closed or penetrating brain injury may result in a wide range of neurological and psychological conditions.

What Are the Basic Types of Traumatic Brain Injury?

An injury to the brain can be inflicted either as a closed or penetrating trauma to the head. While penetrating brain injuries always occur after a skull fracture, or by a protrusion of a sharp and hard object through the cranium, closed traumatic brain injuries occur when the violent blow to the head doesn’t break the skull.

Closed Head Injury

When the skull and the protective membranes of the brain remain intact after a traumatic injury, we label this trauma as a closed head injury. This type of head injury typically has a long-lasting effect on the health of the affected individual.

What Are the Types of Closed Head Injury?

Closed brain injuries often result from car accidents, sporting injuries, acts of aggression, hits by or against hard objects, or a fall. Very often, even a minor head trauma can lead to life-long consequences or even tragic outcomes due to its impact on brain functions.

What Are the Symptoms of Closed Head Injury?

When the brain functions are impaired due to a closed head injury, the affected individual may experience a variety of physical, sensory, psychological, physiological, or cognitive symptoms.

Mild Symptoms

The closed head injury symptoms that are classified as mild include:

Headache in the impacted area;
Dizziness;
Problems with memory;
Problems with vision;
Vomiting;
Swelling (a bump on the impacted area of the head);
Bruises on the impacted area of the head or around the eyes;
Problems with balance;
Irritability;
Confusion;
Sensitivity to loud noise;
Superficial cuts;
Sensitivity to light;
Ringing in the ears.

Sometimes, some of these symptoms may not be obvious immediately after the accident. Depending on whether the symptoms of closed head injury are mild or severe, they can occur from several hours after the impact to the head to several days/months later.

Severe Symptoms

While the aforementioned symptoms are considered as mild, the severe symptoms that occur after a head trauma include:

Severe bleeding from the mouth, nose, ears, or the point of violent physical impact;
Severe and persistent headache spread over the whole head;
Difficulty speaking;
Disturbed patterns of sleep;
Facial paleness;
A severe form of nausea;
Short-term memory loss;
Seizures;
Loss of consciousness;
Coma.

Penetrating Head Injury

When a head injury protrudes the skull and pierces the meninges of the brain, it’s labeled as a penetrating head injury. Since these open head injuries inflict damage to a particular part of the brain, they tend to be localized as a primary head injury of a particular structure of the cerebral cortex.

However, the primary penetrating injury may later develop into a secondary brain injury, impacting larger areas of the brain or causing obstruction to the normal functions of the cortical structures.

These injuries are a medical emergency since they impose some of the highest risks of paralysis or death occurring shortly after the injury.

What Are the Causes of Penetrating Head Injury?

The list of common causes that result in a penetrating brain injury includes:

Sharp objects (knife stabbing, broken glass);
High-velocity objects (such as bullets, or shrapnel after an explosion that pierce the brain through the skull);
Sporting injuries;
Car accidents;
Physical aggression and violence.

What Are the Symptoms of Penetrating Head Injury?

Depending on the severity of the head injury, the affected individual may experience some of the following symptoms:

Severe head bleeding;
Skull fracture;
Slow pulse rate;
Bleeding from the nose, mouth, or ears;
Loss of consciousness;
Obstruction of the airways;
Loss of bladder control;
Inability to move or speak;
A drastic drop in blood pressure;
Facial paleness;
Heart failure due to an insufficient supply of oxygen;
Seizures;
Damaged blood vessels;
Coma.

What Is the Difference Between Primary and Secondary Brain Injury?

Primary Brain Injury

Primary brain injury is the result of a mechanical impact on the head and the cortical structures. It occurs at the moment of the violent blow or jolt to the head. When this type of injury occurs, the skull and the structures of the brain directly suffer damage from the physical impact.

The following traumatic brain injuries are considered as primary:

Cerebral contusion;
Concussion;
Cerebral edema;
Intracranial hemorrhage;
Skull fracture;
Extracranial soft-tissue injuries.

What Are the Symptoms of Primary Brain Injury?

The symptoms of a primary brain injury occur immediately after the accident, and can be experienced as:

Loss of consciousness;
Severe bleeding from any area on the head;
Paralysis;
Loss of ability to speak and swallow;
Heavy breathing or complete obstruction of the airways;
Vomiting;
Dilated pupils;
Blurred vision;
Inability to move the eyes;
Slow pulse rate;
Body numbness.

Secondary Brain Injury

Secondary brain injury results from the complications of primary brain injuries. It occurs due to the dysfunction of the brain structures resulting from the primary injury, dysfunctions such as obstructed blood flow, insufficient oxygen supply to the brain tissues, disrupted functions of the cortical structures, etc.

The following traumatic brain injuries are considered as secondary:

Hypoxia;
Ischemia;
Hydrocephalus;
Brain tumors;
High intracranial pressure;
Various infections.

What Are the Symptoms of Secondary Brain Injury?

These symptoms appear after 12 to 24 hours, or even several days after the primary head trauma and can be experienced as:

Problems with eyesight (blurred vision, seeing double images or flashes);
Loss of memory;
A disturbed sleep pattern (excessive somnolence or inability to fall asleep);
Vertigo;
Fainting;
Changes in eating habits;
Personality changes (irritability, depression, anxiety);
Frequent and severe headaches;
Loss of the sense of smell;
Tinnitus (ringing in the ears);
Inability to speak.

What Are the Major Types of Traumatic Brain Injuries?

The wide range of traumatic brain injuries encompasses the following traumas:

Cerebral contusions;
Concussions;
Intracranial hematoma;
Cerebral edema;
Skull Fractures;
Ischemia;
Diffuse Axonal Injury.

Cerebral Contusions

Cerebral contusions are brain bruises that damage the cortical tissue and the blood vessel networks of the brain. They occur when the capillaries burst under the force of head trauma, such as a blow to the head by a hard object, or falling onto a hard surface.

What Are the Symptoms of Cerebral Contusions?

The symptoms of a cerebral contusion can be classified according to the location of the affected cortical area, and experienced as:

Confusion,
Headache;
Clumsiness;
Vomiting;
Difficulty maintaining balance;
Ringing in the ears;
Dizziness;
Loss of consciousness;
Loss of short-term memory;
Inability to speak.

Concussions

Concussions are typically temporary traumatic brain injuries. They mainly occur after a fall or an injury during physical and sport activities. Concussions of the brain can trigger balance problems, problems with eyesight, anxiety, migraine headaches, neck problems, and mood changes.

What Are the Symptoms of a Brain Concussion?

The main symptoms of a concussion impacting the brain include:

Loss of coordination;
Inability to maintain balance;
Inability to concentrate;
Headaches;
Problems with memory;
Feelings that one’s head is “foggy”.
Slow and/or protracted speech;
Forgetfulness,
Problems with sleeping.

Intracranial Hematoma

When a blood vessel in the brain suffers damage and ruptures, it results in the formation of blood clots outside the broken artery or capillary. A hematoma is a group of blood clots located in any portion of the cerebral cortex. High blood pressure is one of the leading causes of intracranial hematoma.

What Are the Types of Intracranial Hematoma?

We can distinguish four main types of hematoma:

A subdural hematoma (blood accumulation on the surface of the cerebral cortex);
An epidural hematoma (blood accumulated between the brain and the upper brain membrane);
A subarachnoid hemorrhage (blood accumulation between the brain and the meninges);
An intracerebral hemorrhage (blood accumulation among the cortical structures, inside the brain).

What Are the Symptoms of Intracranial Hematoma?

The symptoms pointing to intracranial hematoma include:

Loss of consciousness;
Severe bouts of vomiting;
Dilated pupils;
Problems with speech;
The part of the body that’s opposite from the injured brain side may be paralyzed;
Seizures;
Coma.

Cerebral Edema

Cerebral edema is a swelling of the brain caused by the accumulation of fluids in the skull. The pressure it creates obstructs the blood supply system of the brain, which deprives the cortical structures of oxygen and nutrition. In turn, this results in the destruction of neuron cells.

What Are the Symptoms of Cerebral Edema?

The individual affected by cerebral edema usually experiences the following symptoms:

Pain in the neck;
Loss of consciousness;
Problems with memory;
Seizures;
Nausea;
Strong headaches;
Inability to move;
Inability to speak;
Dizziness.

Skull Fracture

A skull fracture is any physical damage to the cranium. It may result from any head trauma, including falls, car accidents, violent physical attacks, sports injuries, combat, etc.

What Are the Symptoms of a Skull Fracture?

The list of skull fracture symptoms encompasses:

Loss of balance;
Extensive bleeding from the mouth, nose, or ears;
Bruising under the eyes;
Problems with eyesight;
Dilatation of the pupils;
Slow heart rate;
Facial paralysis;
Body paralysis;
Inability to control the bladder;
Tinnitus (ringing in the ears);
Problems with breathing;
Loss of consciousness.

Ischemia

When a traumatic brain injury leads to obstruction of the blood supplying system of the cerebral cortex, it leads to ischemia. It’s a condition that often occurs due to blood clots or accumulation of fatty deposits (plaque) on the arterial walls in the brain.

When the circulation of oxygenated blood is cut off in this way, the neuron cells begin to die out which disturbs the function of the cerebral structures.

What Are the Symptoms of Ischemia?

Depending on the affected brain area, the following symptoms can occur:

Seeing double images;
A weakness of the extremities;
Problems with coordination and balance;
One-sided drooping of the face.

Diffuse Axonal Injury

Diffuse axonal injury is a traumatic brain injury that results from a swift movement of the brain inside the skull due to an external impact. Consequently, the neuron cell axons shear upon the brain’s shifting, inflicting injury to other cortical structures and tissues. Such abnormal movement of the brain inside its bony casing can lead to a coma.

What Are the Symptoms of Diffuse Axonal Injury?

Diffuse axonal injury is often detected via the following warning signs:

Prolonged sleeping;
Lack of energy and motivation;
Disorientation;
Inability to maintain balance;
Nausea and vomiting;
Severe headaches.

What Are the Causes of Traumatic Brain Injuries?

The leading causes of traumatic brain injuries involve:

Falls on a hard surface;
Sporting accidents;
Violent attacks;
Blasts of explosion;
Sharp objects (knife, glass) or weapons;
Hard objects (stone, metal);
Military (combat) accidents;
Car/motorbike accidents.

What Are the Long Term Effects of Traumatic Brain Injury?

Traumatic brain injuries are medical emergencies that potentially have long-term medical consequences. Even though the majority of individuals who have suffered a traumatic brain injury make a successful recovery from the head traumas, some of them may suffer permanently from:

Debilitating headaches;
Depression;
Loss of memory;
Movement disability;
Problems with vision;
Difficulty concentrating and staying focused;
Fatigue;
Dizziness;
Inflammation;
Apoptosis (destruction of the neuron cells);
Seizures.

Fun Facts

Did you know?

Violent and aggressive shaking of a baby or small child can lead to several types of brain trauma, such as swelling of the brain, rotation injuries, or coup/contrecoup injuries.
Locked-in syndrome refers to a neurological condition that usually appears after head trauma. The persons affected by this syndrome are unable to move or speak even though they’re aware of the surroundings and able to reason.
A vegetative state is a condition that occurs after severe brain damage. The affected individuals are completely unaware and unresponsive to their surroundings. In such a condition, only breathing and the circulation of blood are retained.
The Glasgow Coma Scale (GSC) refers to a scale for evaluation of neurological conditions that occur after a traumatic brain injury. It assesses the level of consciousness of intensive care patients after trauma by examining the degree of verbal response, motor functions, and eye movement.
Tracheal intubation is performed in severe trauma patients with obstructed airways. In order to enable breathing, the medical professionals insert a plastic tube into the trachea (the windpipe). This plastic insert is also used for administering drugs to unconscious or anesthetized trauma patients.
Rotation injuries result mainly from a fall directly on the head or the neck that causes dislocation or fracture of the joints.
Coup-contrecoup injuries occur when the brain is hit against the skull. While the coup injury transpires under the area of impact, the contrecoup injury appears on the opposite side of the brain’s impacted area. These injuries often result from motorcycle accidents.
In penetrating head injuries, an object protrudes the skull and remains among the structures of the brain, whereas in perforating head injuries, an object (such as a bullet) pierces the cranium and leaves the head through an exit wound.
Football concussion is what the majority of people have in mind upon mentioning traumatic brain injuries.
No matter how mild it is, a head injury should never be left untreated. Even the mildest bruise or hit of the head may lead to severe and long-lasting health consequences.