National Institute of Neurological Disorders and Stroke (NINDS)What is Traumatic Brain Injury? Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Every TBI is different, and symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. About Brain Injury; BIA-MA. Copyright 2011 Brain Injury Association of Massachusetts.Other symptoms of mild TBI include 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, and trouble with memory, concentration, attention, or thinking. A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation. Is there any treatment? The best treatment for TBI is prevention, such as wearing a seatbelt when in a motor vehicle, and wearing a properly fitted helmet when riding a bike or playing sports like hockey or football. Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury. Primary concerns include ensuring proper oxygen supply to the brain and the rest of the body, maintaining adequate blood flow, and controlling blood pressure. Imaging tests help in determining the diagnosis and prognosis of a TBI patient. Patients with mild to moderate injuries may receive skull and neck X- rays to check for bone fractures or spinal instability. For moderate to severe cases, the imaging test is a computed tomography (CT) scan. Moderately to severely injured patients receive rehabilitation that involves individually tailored treatment programs in the areas of physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support. What is the prognosis? Approximately half of severely head- injured patients will need surgery to remove or repair hematomas (ruptured blood vessels) or contusions (bruised brain tissue). Disabilities resulting from a TBI depend upon the severity of the injury, the location of the injury, and the age and general health of the individual. Some common disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), communication (expression and understanding), and behavior or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness). More serious head injuries may result in stupor, an unresponsive state, but one in which an individual can be aroused briefly by a strong stimulus, such as sharp pain; coma, a state in which an individual is totally unconscious, unresponsive, unaware, and unarousable; vegetative state, in which an individual is unconscious and unaware of his or her surroundings, but continues to have a sleep- wake cycle and periods of alertness; and a persistent vegetative state (PVS), in which an individual stays in a vegetative state for more than a month. What research is being done?
![]() Understand a concussion and the potential consequences of this injury. HEADS UP online training needs to be taken varies. About Us Find BIA in Your State Marketplace Media Center Living with Brain Injury Get. Congress establishes the Defense and Veterans Head. Brain injury policy, program. Maria Crowley, MA, CRC State Head Injury Coordinator. The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. However, it also limits the ability of potentially beneficial agents from reaching the brain. Researchers are exploring ways of combining neuroprotective agents with membrane transporters that are able to carry medications across the blood- brain barrier. Prepared by: Office of Communications and Public Liaison. National Institute of Neurological Disorders and Stroke. National Institutes of Health. Bethesda, MD 2. 08. NINDS health- related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history. All NINDS- prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated. Head Injury - Massachusetts General Hospital, Boston, MAHead Injury. What is a head injury? A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma. ANerv. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain. These are some of the different types of head injuries: Concussion. A concussion is an injury to the head area that may cause instant loss of awareness or alertness for a few minutes up to a few hours after the traumatic event. Skull fracture. A skull fracture is a break in the skull bone. There are 4 major types of skull fractures, including the following. Linear skull fractures. This is the most common type of skull fracture. In a linear fracture, there is a break in the bone, but it does not move the bone. For this type of fracture, your doctor may observe you in the hospital for a brief time. Usually, you will not need treatment and you can resume normal activities in a few days. Depressed skull fractures. You may or may not have a cut in the scalp with this. In this fracture, part of the skull is actually sunken in from the trauma. This type of skull fracture may require surgery, depending on the severity, to help correct the deformity. Diastatic skull fractures. These fractures occur along the suture lines in the skull. The sutures are the areas between the bones in the head that fuse during childhood. In this type of fracture, the normal suture lines are widened. Newborns and older infants are more likely to get these types of fractures. This is the most serious type of skull fracture, and involves a break in the bone at the base of the skull. With this type of fracture, you may have bruises around the eyes and a bruise behind the ear. You may also have clear fluid draining from the nose or ears due to a tear in part of the covering of the brain. If you have this type of fracture, you will require close observation in the hospital. Intracranial hematoma (ICH). An intracranial hematoma is a blood clot in or around the brain. There are different types of hematomas, classified by their location in the brain. These can cause mild head injuries to quite serious and potentially life- threatening injuries. The different types of intracranial hematomas include. Epidural hematoma. Epidural hematomas occur when a blood clot forms underneath the skull, but on top of the tough covering that surrounds the brain (the dura). They usually come from a tear in an artery that runs just under the skull. Epidural hematomas are usually associated with a skull fracture. Subdural hematoma. Subdural hematomas occur when a blood clot forms underneath the skull and underneath the dura, but outside of the brain. These can form from a tear in the veins that go from the brain to the dura, or from a cut on the brain itself. They are sometimes, but not always, associated with a skull fracture. Contusion or intracerebral hematoma. A contusion is a bruise to the brain itself. A contusion causes bleeding and swelling inside of the brain around the area where the head was struck. Contusions may occur along with a fracture or other blood clots. Bleeding that occurs inside the brain itself can sometimes occur spontaneously. When trauma is not the cause, the most common causes are long- standing high blood pressure in older adults, bleeding disorders in either children or adults, or the use of medicines. These injuries are common and are usually caused by shaking of the brain back and forth, which can happen in car accidents, from falls, or shaken baby syndrome. Diffuse injuries can be mild, such as with a concussion, or may be very severe, as in diffuse axonal injury. If severe, you may be in a coma for a prolonged period, with injury to many different parts of the brain. What causes a head injury? There are many causes of head injury in children and adults. The most common traumatic injuries are from motor vehicle accidents (automobiles, motorcycles, or struck as a pedestrian), from violence, from falls, or from child abuse. Subdural hematomas and brain hemorrhages can sometimes happen spontaneously. When there is a direct blow to the head, shaking of the child, or when a whiplash- type injury occurs, the brain jolts backwards and hits the skull on the opposite side, causing a bruise. The jarring of the brain against the sides of the skull can cause tearing of the internal lining, tissues, and blood vessels that may cause internal bleeding, bruising, or swelling of the brain. Who is at risk for a head injury? Young children, older adults and males are at most risk for head injuries. These are the most common symptoms of a head injury. Mild head injury. Symptoms include. Symptoms may include any of the above plus. The full extent of the head injury may not be completely understood immediately after the injury. You will need comprehensive evaluation and testing. A physical exam and other tests help make the diagnosis of a head injury. During the exam, the healthcare provider will ask about your medical history and how you were injured. Trauma to the head can cause neurological problems and may require further medical follow up. Diagnostic tests may include: Blood tests. X- ray. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X- rays. Electroencephalogram (EEG). Your healthcare provider will determine the best treatment based on: How old you are. Your overall health and medical history. How sick you are. How well you can handle specific medicines, procedures, or therapies. How long the condition is expected to last. Your opinion or preference. Depending on the severity of the injury, treatment may range from ice and rest to observation to surgery. For a severe head injury, you are monitored for increased intracranial pressure (pressure inside the skull). Head injury may cause the brain to swell. Since the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase, which can lead to brain damage. He or she will then attach the ICP device to a monitor that gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away. While the ICP device is in place, you will be given medicine. Your doctor will remove the device when the swelling has gone down and there is little chance of more swelling. What are the complications of a head injury? A head injury can result in loss of muscle strength, fine motor skills, speech, vision, hearing, or taste function, depending on the brain region involved and the severity. Long- or short- term changes in personality or behavior may also occur. You may need long- term medical and rehabilitative (physical, occupational, or speech therapy) management. Can head injuries be prevented? The key to head injury prevention is to promote a safe environment for children and adults and to prevent head injuries from occurring in the first place. The following measures can help prevent head injury: Use car seats and seat belts when riding in the car and helmets (when worn properly) for activities, such as bicycle riding, in- line skating, skiing, and skateboarding. Prevent falls. Since older adults are prone to falls, it is important to make their living areas safe by removing throw rugs or clutter that may cause them to trip, installing handrails in the bathroom and stairways, and assuring that there is good? Seek immediate medical attention if any of these occur: A laceration (cut)Persistent or increasing sleepiness or confusion. Seizure, repeated vomiting, or severe headache. Inability to feel an arm or leg or recognize people. Loss of balance. Difficulty speaking, seeing, or breathing. Loss of consciousness. Key points about head injury. A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. The most common traumatic injuries are from motor vehicle accidents from violence, from falls, or from child abuse. Moderate to severe head injury requires immediate medical attention. Severe head injury requires close monitoring for increased intracranial pressure. Prevention is most important by promoting a safe environment for children and adults through the use of car seats, seat belts, and helmets, and removing tripping and fall hazards in the home. Next steps. Tips to help you get the most from a visit to your healthcare provider: Know the reason for your visit and what you want to happen. Before your visit, write down questions you want answered. Bring someone with you to help you ask questions and remember what your provider tells you. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you. Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are. Ask if your condition can be treated in other ways. Know why a test or procedure is recommended and what the results could mean. Know what to expect if you do not take the medicine or have the test or procedure. If you have a follow- up appointment, write down the date, time, and purpose for that visit. Know how you can contact your provider if you have questions.
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