Have you ever wondered what happens to your brain when you hit your head hard, or when you get injured by something hitting your head? Sometimes these types of events can be more serious than you think. Today we are going to talk about this type of skull injury, a condition called Traumatic Brain Injury (TBI) . This is a serious medical condition that actually affects the functioning of our brain.
What exactly is Traumatic Brain Injury (TBI)?
Simply put, a traumatic brain injury (TBI) is damage to the brain caused by a hard blow to the head, a jolt, or an object penetrating the skull and entering the brain. Think of it this way: just like a coconut falling from a high cliff and the water inside it is released, our brain is also inside the skull, so if you hit your head hard, the brain can hit the inside of the skull. Or, if something sharp hits your head, it can penetrate the skull and damage the brain.
This condition, called TBI, is a leading cause of death and long-term disability in countries like the United States. It can cause both short-term and long-term health problems. That means it can affect every aspect of your life. But the good news is, there are treatments for it. More importantly, there are ways to prevent these types of accidents.
We often hear about head injuries like this in Sri Lanka, don't we? Falling off a bicycle, hitting your head while playing sports, car accidents... all of these can cause TBI. Therefore, it is very important to be aware of this.
How common is TBI?
This is actually a more common condition than you might think. For example, in 2020, more than 214,000 people in the United States alone were hospitalized for TBI. And more than 69,000 people died from TBI-related complications. So this is not something to be taken lightly.
What are the types of traumatic brain injury (TBI)?
Doctors divide these TBIs into two main types:
1. Penetrating TBI: This is when something sharp (such as a bullet, knife, or piece of metal) penetrates your skull and damages brain tissue. Doctors sometimes call this an ``Open TBI''.
2. Non-penetrating/Blunt TBI: This happens when your head is hit hard, causing the brain to move or twist inside the skull. Doctors also call this a ``Closed head TBI'' or ``Blunt TBI''. This can happen in a car accident, a fall, a blow to the head, an explosion, or a blow to the head while playing sports.
Additionally, doctors also classify TBI conditions as mild, moderate, and severe .
- Mild TBI: This is the most common type, accounting for more than 75% of all TBIs. Sometimes doctors also refer to this mild TBI as a concussion . However, even though it is mild, it can still cause significant, long-term problems. A person with a mild TBI may have difficulty returning to daily activities, such as going to work.
- Moderate and Severe TBI: Both of these conditions often result in significant, long-term health problems.
What are the symptoms of a TBI?
If you have a TBI, it means that your head has been hit somewhere and your brain has been moved or twisted inside your skull. When this happens, your brain can be damaged and the blood vessels in your brain can be injured. A TBI causes chemical changes in your brain, causing brain cells to stop working properly.
The symptoms of a TBI vary depending on whether it is mild, moderate, or severe. However, any TBI can cause symptoms. These can include physical problems, difficulty thinking and remembering, and social or emotional problems. Both adults and children have similar symptoms. However, if a young baby has a TBI, they may have symptoms such as difficulty eating or breastfeeding, or they may cry uncontrollably no matter how much they are comforted.
Symptoms of a Mild TBI
The symptoms of a mild TBI vary. They can appear immediately after the injury, a few days later, or even a week later. You may not notice a connection between the head injury and the discomfort you feel. Also, symptoms can change as the brain heals.
There are several main types of symptoms:
Physical problems:
- Nausea and vomiting
- Dizziness or loss of balance
- Headache
- Inability to look at light (eyes seem to turn blue)
- Fatigue, feeling of weakness
- Vision problems, for example, blurred vision
Problems thinking or remembering:
- Confusion
- Difficulty concentrating
- Difficulty thinking clearly
- Short-term memory loss
- Feeling like everything is happening slowly, like you're in slow motion.
- Grogginess
Social or emotional problems:
- Anxiety
- Frequent anxiety
- Irritability
Sleep problems:
A mild TBI can also affect your sleep. This can include difficulty falling asleep, sleeping less than usual, or sleeping more than usual.
Symptoms of a Moderate or Severe TBI
Like mild TBI, symptoms of moderate or severe TBI can change over time.
Physical problems:
These can be very serious, for example:
- Loss of consciousness. A moderate TBI can last for more than 30 minutes and less than 24 hours. A severe TBI can last for more than 24 hours.
- Coma
- Weakness in the arms and legs
- Problems with balance and coordination
- Hearing or vision problems
- Changes in sensations, such as touch
Problems thinking or remembering:
A moderate or severe TBI can cause symptoms like:
- Confusion
- Difficulty concentrating
- Difficulty thinking clearly
- Short-term memory loss
- Difficulty communicating with others
- Grogginess
Social or emotional problems:
A moderate or severe TBI can cause symptoms like:
- Anxiety
- Frequent anxiety
- Irritability
- Sadness, regret
- Depression
- Anger
- Aggression
- Difficulty controlling behavior
- Working more recklessly than usual
What are the possible complications of TBI?
Mild, moderate, and severe TBI can cause various complications.
If you have a mild TBI, and you don't give your brain enough time to heal, you're at increased risk of developing a life-threatening condition called second-impact syndrome . This is when the brain suddenly swells and brain tissue shifts from place to place.
Moderate or severe TBI can cause long-term consequences, including:
- Brain bleed
- Seizures
- Permanent brain damage and disabilities
- Shortening of life span
In addition, moderate or severe TBI increases the risk of developing conditions such as:
- Alzheimer's disease
- Anxiety
- Chronic Traumatic Encephalopathy (CTE) (a disease that occurs in people who suffer frequent blows to the head, such as athletes)
- Depression
- Movement disorders
- Post-Traumatic Stress Disorder (PTSD)
How is TBI diagnosed?
If you think you have a mild TBI, your doctor will examine you and ask about your symptoms. They will also try to find out what caused the injury. They may do tests like:
- Neurological evaluation
- Imaging tests. A CT scan or MRI may be done to check for bleeding or swelling in the brain.
- Blood tests
If you have a moderate or severe TBI, your doctor will likely order blood tests and a CT scan to determine what immediate medical treatment is needed.
What are the treatments for TBI?
There are different treatments for mild and moderate/severe TBI. Specific treatments may vary depending on your condition.
Treatment for mild TBI
If you have a mild TBI, doctors may recommend the following:
- Rest: This is the most important thing. You need to give your brain time to heal.
- Non -NSAID painkillers that can be taken without a doctor's prescription (e.g. paracetamol. But it's best to ask your doctor.)
- Going for regular medical checkups to see if new symptoms appear or if existing symptoms worsen over the next few weeks.
Treatment for moderate or severe TBI
Moderate or severe TBI is a medical emergency. Doctors may perform surgeries such as:
- Reduce the pressure inside the skull.
- In the case of a penetrating TBI (meaning something breaks through the skull and enters the brain tissue), remove any debris inside the skull.
- Remove blood clots.
- Repair fractures in the skull.
- Install monitors that can measure pressure and oxygen levels inside the brain.
Doctors may also prescribe medications like these:
- Painkillers prescribed by a doctor.
- Antiseizure medications.
- Medications that prevent blood clots in the veins (venous thromboembolism).
- Stimulants that increase alertness.
- Antidepressants.
- Medications for anxiety (Anxiolytics).
After you recover from surgery, you will likely begin rehabilitation treatment. The goal of rehabilitation is to improve your ability to perform daily activities and help you manage challenges such as communication or mental health problems. You may receive treatments such as:
- Physical therapy
- Occupational therapy
- Speech therapy
- Respiratory therapy
- Psychological therapy to help with any emotional or mental health problem
Is it possible to fully recover from a TBI?
It really depends on your situation. Every TBI can have challenges. In some cases, a TBI can have long-term effects. If you have a TBI, ask your doctor what you can expect.
Important: Everyone's recovery process is different, so don't compare yourself to others. Follow your doctor's instructions exactly.
Can TBI be prevented?
You may not be able to avoid everything that can cause a TBI. However, there are things you can do to protect your head and reduce your risk of TBI. Here are some of them:
- Reduce your risk of falls: If you're over 65, you're at higher risk of falling. Consider installing handrails on stairs and creating clear, safe pathways around your home (for example, removing rugs, long electrical cords, and small furniture items that could trip you up).
- Play safely: Wear protective gear (like a helmet) if you play contact sports, ride bicycles, or ride motorcycles.
- Fasten your seat belt: When driving, wear your seat belt and make sure that others with you are also wearing seat belts. When traveling with small babies and children, always keep them in car seats or booster seats.
I have a mild TBI. How can I take care of myself?
Most people with mild TBI get better with a few days of rest. If you have a mild TBI, you can take care of yourself by:
- Avoid activities that could re-injure your head and brain.
- If you have a headache, ask your doctor what painkillers you can use and when to use them.
- Get plenty of rest. Your brain needs time to heal. If you have trouble sleeping, talk to your doctor about things you can do to get better sleep.
When should people with TBI go to the emergency room?
If you have a TBI, seek medical help immediately if you have any of these symptoms:
- If the headache doesn't go away, or if it gets worse.
- If the vomiting doesn't stop.
- Slurred speech.
If you are caring for someone with TBI, seek medical help immediately if you notice any of the following:
- They're unconscious, and you can't wake them up.
- If they have convulsions.
- If you notice that the black pupil in one of their eyes is much larger than the other eye.
Someone close to me has a moderate or severe TBI. How can I help them?
If you are caring for someone with TBI, you may need support and guidance on how to help them rebuild their lives. Here are some suggestions:
- Learn how TBI affects them. Knowing what to expect can help you better support your loved one as they face challenges.
- Encourage them to participate in therapy.
- Do everything you can to help them get enough rest.
- Take care of yourself too. Caring for someone with a severe TBI can be very tiring and stressful. Ask your loved one's doctors about services and programs that can help you get some respite.
- Join a support group. Connecting with people who understand what you're going through can help you feel like you're not alone.
What questions should I ask my doctor?
If you have a mild TBI, you can ask your doctor these questions:
- What type of TBI do I have?
- Will I need surgery or therapy?
- When will I get better?
- When will I be able to go back to work or school?
If you are caring for someone with severe TBI, you might ask yourself these questions:
- What are the treatment options?
- What kind of rehabilitation will they need?
- What are the chances of them recovering?
- How can I help them deal with this situation?
Finally, things to remember (Take-Home Message)
Traumatic brain injury (TBI) , a serious head injury, can be life-threatening in the worst cases. But even a mild TBI can change your life. A TBI can occur when you hit your head or something hits your head. These can cause short-term or long-term problems, and they can affect every aspect of your life. A TBI can change the way you think, behave, feel, and learn. It can also affect your ability to work and build relationships.
TBI can be caused by many things, including unexpected falls, car accidents, and interpersonal violence. There is no guarantee that you will be able to avoid everything that can cause a TBI. But you can take steps to reduce your risk. If you are concerned that you may be at risk for a TBI, ask a doctor about how to protect yourself and your brain from a TBI. Your head is a precious thing, and it is your responsibility to take care of it.
` TBI, brain injury, head injury, concussion, skull injury, brain damage, neurological disorders
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