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Traumatic Brain Injury 101



 helmet.jpgAny injury to the head may cause traumatic brain injury (TBI), which is also known as intracranial injury.  The two main types of TBI are closed head injuries and penetrating injuries.  Closed head injuries occur from a blow to the head, like when someone hits his or her head on the windshield during a car accident.  During these blows the brain slams into the skull.  Penetrating injuries occur when a foreign object, such as a bullet, enters the brain and causes localized damage.  

Closed head injuries can cause two different types of brain damage: primary and secondary.  

Primary brain damage is complete at the time of impact and may include:
•    lacerations
•    skull fracture
•    bruises/contusions
•    blood clots/hematomas
•    nerve damage

Secondary brain damage evolves over a period of time after the initial trauma and includes:
•    fever
•    anemia
•    epilepsy
•    hematoma
•    brain swelling (edema)
•    intracranial infection
•    intracranial pressure
•    low or high blood pressure
•    abnormal blood coagulation
•    cardiac or lung changes
•    too much or too little carbon dioxide

Depending on the extent of the damage, symptoms of TBI can be mild, moderate, or severe.  TBI can cause a host of physical, cognitive, social, emotional, and behavioral effects, and outcomes range from complete recovery to permanent disability or death.   

Those who are most at risk for TBI include children (especially from birth to 4 years of age), teenagers (particularly between 15 to 19 years of age), and adults over the age of 65.
Children and Brain Injuries
If your child receives a blow to the head, consult with a physician immediately.  Young children lack the communications skills needed to report confusion, sensory problems, headaches, or other symptoms.  A child with traumatic brain injury may experience:

•    persistent crying
•    inability to be consoled
•    sad or depressed moods
•    change in sleep habits
•    unusual irritability
•    loss of interest in favorite toys or activities
•    change in nursing or eating habits
•    change in ability to pay attention

To assess the severity of brain injury, healthcare workers use a 15-point test called the Glasgow Coma Scale.  Doctors check for a person’s ability to follow directions, move their eyes, and move their limbs.  They also study the coherence of speech, which offers important clues as to the extent of the brain injury.  Imaging tests, like CT scans and MRIs, can show internal bleeding, bruising, and blood clots.  

Traumatic brain injury is a causative factor for accelerated hormonal deficiencies, which can lead to:
•    anxiety
•    angry outbursts
•    depression
•    mood swings
•    memory loss
•    learning disabilities
•    inability to concentrate
•    sleep deprivation
•    obesity
•    menstrual irregularities
•    premature menopause
•    loss of libido
•    muscular weakness

Hormone deficiencies can be detected using a home testing kit.  Once an imbalance is discovered, a healthcare practitioner can begin to treat the condition.    

There are some things that you can do prevent TBI.  For example, lessen the likelihood of dangerous falls by providing adequate lighting on stairs and in driveways.  Keep paths clear of furniture or other objects that could cause someone to fall down.  When driving, obey all traffic laws and wear seat belts – and of course, never drive when you have been drinking of taking drugs.  When participating in recreational activities, like riding bicycles or horseback riding, wear a helmet to protect your head. 

 

Jennifer Cebulak

Research Editor

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.