Brain injury

Traumatic brain injury

A traumatic brain injury ("TBI") is an alteration in brain on a structural, physiologic, chemical and/or neurotransmitter pathway as well as other evidence of brain pathology, caused by an external force. (“About Brain Injury”). A post-traumatic brain injury is the alteration of the neurologic function by the TBI event. Multiple TBI events can lead to chronic traumatic encephalopathy.

Concussion

A concussion is the most common type of traumatic brain injury. It can be caused by direct damage to the head, gunshot wounds, violent shaking of the head (very common in children), or force from a whiplash type injury. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. The blood vessels in the brain may stretch, and cranial nerves may be damaged.

Contusion

A contusion could be caused by direct damage to the head, where a bruise is bleeding on the brain.

Coup-contrecoup injury

A coup-contrecoup injury occurs when the force impacting the head is not only strong enough to cause a contusion at the site of impact, but also able to move the brain and cause it to slam into the opposite side of the skull, which causes the additional contusion.

Diffuse axonal injury

A diffuse axonal injury can be caused by strong shake on the head, as in "shaken baby syndrome", or by rotational forces, such as a car accident. Injury occurs when the unmoving brain lags behind the movement of the skull and causes the brain structures to tear. The tearing of the nerve tissue disrupts the brain communication and chemical processes. This disturbance in the brain would cause brain damage or death. There are specific areas that will shear connections within the brain substance that are indicative of a diffuse axonal injury.

Locked in syndrome

Locked in syndrome is a rare neurological condition wherein the patient is unable to physically move any part of the body except the eyes. The patient is still conscious and able to think.

Penetrating injury

A penetrating injury occurs when a sharp object enters the brain. This causes a wide area of damage. The penetrating injuries caused by bullets have a 91% mortality rate overall.

Acquired brain injury

An acquired brain injury is an injury to the brain that has occurred after birth. It is not hereditary, congenital, degenerative, or induced by birth trauma.

Anoxic brain injury

Anoxic brain injury occurs when the human brain doesn’t receive any oxygen. Cells in the brain need oxygen to survive and function.

Hypoxic brain injury

Hypoxic brain injury happens when the brain receives insufficient oxygen. A hypoxic brain injury, also called stagnant hypoxia, is caused by the critical reduction in blood flow or low blood pressure which leads to the lack of blood flow to the brain.

Traumatic brain injury

Mild traumatic brain injuries needs no treatment other than rest. The treatment for Emergency traumatic brain injuries focuses on making sure the patient has enough oxygen, blood supply and trying to keep the blood pressure, and avoid further injury from the head or neck. The emergency traumatic brain injuries might need to take surgeries which are removing clotted blood, repairing skull fractures or cut a hole in the skull. The drugs that are used for the Traumatic Brain Injury are Diuretics, Anti-seizure drugs and Coma-inducing drugs. Diuretics would reduce the fluid in tissues which helps reduce the pressure inside the brain. In the first week of the traumatic brain injury, patients have a risk of having seizures. Anti-seizure drugs would prevent patients from the seizures. Coma-inducing drugs would temporary comas the patients and requires less oxygen to function which is very helpful during the surgery. (“Traumatic Brain Injury”)

Common problems after brain injury

Brain injuries have far-reaching and varied consequences due to the nature of the brain as the main source of bodily control.

Patients commonly experience issues with memory. This can be issues with either long or short term memories depending on the location and severity of the injury. Memory can improve through rehabilitation but in some cases the damage can be permanent

Brain injury can also affect movement and muscle control ranging from difficulty writing to an inability to perform basic bodily functions including swallowing or coughing.

Behavioural and personality changes are also commonly observed due to changes in the structure of the brain in areas controlling hormones or major emotions.

Headaches and pain can also occur as a result of a brain injury either through the damage to the brain and head or neck area or due to neurological conditions stemming from the injury.

Due to the changes to the brain as well as the issues associated with the change in physical and mental capacity depression and low self-esteem are common but can be treated with psychological help. Antidepressants must be carefully considered in brain injury patients as these work by altering brain chemistry which can have undesired effects due to the already altered brain chemistry caused by the injury.

Are children and adults affected differently?

The human brain would keep developing until age 20 to 25. If the brain is damaged during this time, then the patient physically might fully recover, however, they will not be able to pick up some new skills. The children's brain is easier to get damaged (“What Is Acquired Brain Injury?”). The time to recover the injury for children also takes 6 to 10 times more than the adults. Jeffrey Barth, PhD in the University of Virginia School of Medicine did an experiment which gives child or adult mice a mild brain injury and record how many days it would take to recover. Jeffrey Barth, PhD stated that “the children is more vulnerable to injury and will take 6 to 10 times more time to recover than the adult” (Barth).