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Jack Sisson's TBI Blog
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Sunday, May 20, 2012
What you need to know about traumatic brain injuries
From Fox News:
Traumatic brain injury (TBI) occurs when an external force, such as a violent blow, damages the brain. Depending on the severity of the injury, this could end in serious long-term damage or even death. Centers for Disease Control and Prevention report that about 1.7 million people will experience a TBI each year.
The Individuals with Disabilities Education Act (IDEA) is the special education law in the United States. It defines TBI as "an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment."
Ricardo Jorge Komotar, neurological surgeon at the University of Miami School of Medicine, said that people should know about the chronic nature of the condition. "Most of the focus is on concussions but people need to understand that there are repercussions 10 to 15 years down the road, not just right now."
Frank Toral, senior partner at Toral Garcia Battista (a brain and spinal cord injury law firm), explained that TBI the leading cause of death and disability for children 14 and under.
There are two basic forms of TBI: Closed head injuries (blows to the head) and penetrating injuries (penetration of brain by foreign object). One can receive TBI from acts of violence, sports injuries, blasts during combat or falls, reports the Mayo Clinic.
An external physical blow can damage brain cells, cause the brain to push harshly against the skull, tearing internal structures or causing internal bleeding.
The American Speech-Language-Hearing Association reports that primary brain damage (which is complete at time of impact) can include skull fractures, contusions, blood clots, tearing of the lobes or blood vessels and nerve damage. Secondary damage (which evolves over time after impact) can include brain swelling, epilepsy, fever, infection, extreme blood pressure, anemia and more.
Owing to the brain's intricacy, the complications are predicated upon the particular section harmed. Scientists separate the brain into various lobes: frontal lobe, temporal lobe, parietal lobe, occipital lobe, the cerebellum and the brain stem--each responsible for particular functions.
The Brain Injury Association of America explains, for instance, that the occipital lobe controls vision, whereas the cerebellum controls balance, motor activity and coordination. However, these sections are not mutually exclusive and responsibilities may overlap, as visual perception is partially controlled by the cerebellum.
To assess the severity of the injury, doctors gauge the patient's capabilities to follow directions on the 15-point Glasgow Coma Scale. If medical personnel are responding in the immediate aftermath of the blow, they will interview witnesses to uncover specifics, such as how long the person has been unconscious, where the head was struck and how the injury occurred, among other details.
Imaging tests (MRIs, CT scans) are vital to properly understanding the kind and scope of injury sustained.
Since tissue swelling may transpire (increasing the internal pressure, which leads to further damage), doctors might use a probe to monitor the intracranial pressure.
No two brain injuries are identical, so treatment varies considerably. Komotar emphasized that the key is giving the brain enough time to recover.
In the immediate aftermath of the traumatic injury, treatment focuses on ensuring that the brain receives sufficient oxygen and blood. Particular care is given to the neck and head to prevent further injury.
To prevent secondary damage, multiple drugs may be provided: temporary coma-inducing drugs (a person in a coma needs less oxygen in his/her brain), anti-seizure drugs and diuretics (relieves some pressure on brain).
Surgery and rehabilitation depends greatly on a specific patient's particular trauma.
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