This month is Brain Injury Awareness Month, and a good time to talk about traumatic brain injury and its consequences. Traumatic brain injury (TBI), sometimes called “closed head injury,” occurs when an individual experiences a sudden, violent jolt or blow to the head.
Sometimes, TBI occurs from the recoil action when the head is struck, called a “contrecoup” injury, which produces shearing damage to the delicate nerve fibers that make up the brain’s network. Countercoup injuries typically involve damage to areas of the brain opposite to where the blow occurred.
Damage to the brain varies with the severity of the blow. Penetrating trauma to the head is another cause of traumatic brain injury.
TBI is commonly caused by motor vehicle accidents, falls, and other instances of blunt trauma to the head – either unintentional or intentional (acts of violence). Sports injuries are also a common cause of TBI, as highlighted by the recent wave of former NFL players claiming permanent brain damage due to repeated head blows while playing football.
While whiplash occurs in the cervical region of the spine, a similar mechanism can also cause neural damage through shearing mechanisms in the case of violent movement of the head, which may swing backwards in response to a strong force such as a car hitting a tree. Abused infants often suffer from shaken baby syndrome, which is discovered by characteristic findings in their retina. Difficult deliveries may result in traumatic brain injury in the newborn.
The effects of traumatic brain injury vary, and in some cases, a jolt or blow to the head will cause no injury at all. However, if you are suffering from persistent headaches, nausea and vomiting, seizures, altered level of consciousness or inability to awaken from sleep, you must go to the Emergency Department immediately. Other sinister findings include slurred speech, numbness, loss of coordination, dilation of one or both pupils, and agitation. These are signs of an immediate medical emergency, and you must present to the closest Emergency Department.
Treatment of severe traumatic brain injury requires the services of a neurosurgeon, who will work to prevent swelling of the brain in response to the injury. The protective skull is a closed compartment, and there is no space for swelling of the delicate tissues of the brain within the cranial cavity.
If you or a loved one has suffered a traumatic brain injury, the long term consequences may be significant and may include severe neurologic deficits, problems with memory and attention, loss of control over motor functions, confusion, fatigue, cognitive impairment and emotional lability, or mood swings. Recovery after prolonged loss of consciousness results in a poorer prognosis, and often involves months of intense rehabilitation, usually in a special facility with a multi-disciplinary team. The goal is to recover lost brain function, or to allow a healthy part of the brain begin to compensate for the region of injury.
Although minor blows or injuries to the head may result in a mild concussion, or mild TBI, defined by loss of consciousness or confusion and disorientation for less than 30 minutes, usually with no need for hospitalization, these injuries can have significant consequences lasting months to a year. There may be no findings on imaging studies. There is evidence that post-concussive syndromes may include frequent migraine headaches, depression, and loss of cognitive function. You should always be evaluated by a neurologist in the case of onset of any unusual symptoms after a blow to the head.
If your injury or that of a family member was caused by the negligence of another person, or through criminal misdeed, you may have recourse to compensation for your injuries. It is important that you document any changes and deficits that you notice in your level of functioning, so that you can better describe to both medical and legal professionals any detrimental changes you have suffered as a result of your head injury.