Traumatic brain injury (TBI)

Overview  

Traumatic brain injury (TBI) is a critical health condition that impacts brain function. It can occur when an object, like a bullet or a fragment of skull, penetrates the brain tissue. A mild TBI might temporarily disrupt brain cells, while a more severe TBI can cause bruising, tissue tears, bleeding, and other physical damage to the brain. Such injuries can lead to long–term issues or even be fatal.  

Traumatic brain injuries (TBIs) are categorized into two main types: penetrating and non–penetrating (blunt).  

• Penetrating TBI: This type occurs when an object pierces the skull and damages brain tissue. Commonly referred to as open TBI, it can result from injuries caused by sharp objects such as shrapnel, bullets, or knives. 
• Blunt TBI: Also known as non–penetrating or closed head TBI, this occurs when an impact to the head causes the brain to move or twist within the skull. Common causes include vehicle accidents, falls, sports injuries, or being struck on the head. 

Healthcare providers further classify TBIs into three severity levels: mild, moderate, and severe. 

• Mild TBI: Accounting for over 75% of all TBIs, mild TBIs can still lead to significant and long–term difficulties. A concussion is a common term used for mild TBIs. Individuals may experience challenges in resuming their daily activities, including work. 
• Moderate and severe TBI: Individuals with moderate to severe TBIs often face substantial and long–lasting health complications. 

However, there are treatments available for TBI, and importantly, there are preventive measures to reduce the risk of occurrence. 

Symptoms  

Traumatic brain injury happens when the brain experiences a forceful impact, causing it to twist or bounce within the skull. This can lead to the risk of brain damage and injury to cerebral blood vessels. Additionally, the brain’s chemistry undergoes changes following a traumatic brain injury, disrupting the normal functioning of brain cells. 

A traumatic brain injury can result in a wide range of psychological and physical effects. Following the traumatic occurrence, certain signs or symptoms could show up right away, while others might take days or weeks to show up. 

• Mild traumatic brain injury: The following are potential signs and symptoms of mild traumatic brain injury:  

• • Physical symptoms  

• Dizziness or loss of balance  
• Drowsiness  
• Fatigue  
• Headache  
• Nausea or vomiting  
• Speech problem  

• • Sensory symptoms  

• Blurred vision.  
• Changes in smell  
• Ringing in the ears.  
• Sensitivity to light or sound  
• Unpleasant taste in the mouth.  

• • Cognitive, behavioral, or mental symptoms  

• Depression or anxiety.  
• Difficulty to sleep.  
• Getting more sleep than normal  
• Mood swings.  
• Problem of concentration or memory.  
• State of being dazed, confused, or disoriented instead of a loss of consciousness.  
• Temporary loss of consciousness.  

• Moderate to severe traumatic brain injuries: Any of the signs and symptoms of a mild injury, as well as the following indications that could manifest in the initial hours or days following a head accident, can indicate a moderate to severe traumatic brain damage:  

• • Physical symptoms  

• Clear liquids dripping from the ears or nose  
• Convulsions or seizures.  
• Frequent vomiting or nausea.  
• Having trouble waking up from sleep  
• Headache that never goes away or becomes worse.  
• Inability to coordinate.  
• Loss of consciousness for several minutes to hours.  
• One or both of the eyes’ pupil’s dilation  
• Weakness or numbness in the toes and fingers  

• • Cognitive or mental symptoms  

• Agitation, aggressiveness, or other unusual conduct  
• Coma and other disorders of consciousness  
• Profound confusion  
• Slurred speech  

• Children’s symptoms: Headaches, sensory issues, disorientation, and other related symptoms may not be communicated by infants and young children who have brain damage. When a child has a traumatic brain injury, you could notice:  

• • Change in eating or nursing habits.  
  • Irritable.  
  • Constant crying and an not able to be comforted.  
  • Unable to pay attention.  
  • Change in sleep pattern.  
  • Seizures.  
  • Sad, depressed, or drowsy.  
  • Loss of interest in playing games or toys.  

Always consult a doctor if you or your child experiences a significant impact to the head or body that causes concern or behavioral changes. Seek immediate medical attention for any signs of TBI, which can occur when the head is struck forcefully enough to cause the brain to move within the skull, potentially damaging brain cells and blood vessels. This can lead to chemical changes that impair brain function. Symptoms of TBI vary in severity but generally include physical difficulties, cognitive impairments, and emotional or social issues. In infants, symptoms may manifest as persistent crying and feeding problems. Prompt medical evaluation is crucial, regardless of the injury being classified as mild, moderate, or severe.  

Causes 

The most common cause of traumatic brain injury is a blow to the head or other severe body injury. A number of factors, such as the type of injury and the impact force, can affect how much damage is done.  

Traumatic brain injury is commonly caused by the following incidents:  

• Falls: The most common cause of traumatic brain injury overall is falls—especially from beds or ladders, down stairs, in the bath, and other falls—especially in elderly persons and small children.  
• Vehicular accident: Traumatic brain injury can often be caused by accidents involving automobiles, motorcycles, bicycles, and pedestrians involved in these types of incidents.   
• Violence : Common causes include gunshot wounds, domestic violence, child abuse, and other attacks. Babies that experience severe shaking may suffer from traumatic brain injury, or “shaken baby syndrome.”  
• Sports injuries: Sports injuries from a number of sports, such as hockey, skateboarding, football, baseball, lacrosse, boxing, soccer, and other high–impact or extreme sports, can result in traumatic brain injury. Among young people, these are very common.  
• Explosive blasts and other combat injuries: Traumatic brain injuries among active–duty military soldiers are frequently caused by explosive blasts. Many researchers think that the pressure pulse traveling through the brain seriously impairs brain function, even though it is yet unclear how the harm is caused.  

Penetrating wounds, severe strikes to the head with shrapnel or debris, falls, or physical impacts with objects after a blast can also cause traumatic brain damage.  

Risk factors 

The following people are most susceptible to traumatic brain injury:  

• Children, especially from birth to the age of 4.  
• Young adults, in particular those in the 15–24 age range  
• Adults who are at the age 60 and older 
• It is common among men.