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Traumatic Brain Injuries: Symptoms & Treatment

Instructor: Amanda Robb
This lesson will focus on traumatic brain injury. Here, we'll learn what causes traumatic brain injury, what happens to the brain and the symptoms patients experience. Then we'll go over the two main types of traumatic brain injury as well as the treatment.

What Is Traumatic Brain Injury?

Friday night lights illuminate high school football fields across the nation. Young athletes run onto the field, cheered on by classmates and family. Students work in concession stands serving snacks to cold fans, raising money for various clubs at school. However, with the sprints, tackles, and falls come something less pleasant than popcorn and soda: traumatic brain injury (TBI), or a force applied to the head that causes brain damage.

Football has been under especially intense scrutiny for traumatic brain injury in players in light of recent deaths due to a specific type of injury caused by multiple concussions. Researchers at Boston University analyzed 165 football players at the high school, college, or professional level and found that 70% of them suffered from traumatic brain injury. To understand more about this increasingly relevant injury, let's look at some of the general causes of TBI and compare the symptoms of mild and moderate to severe brain injury before examining specific types.

General Causes and Symptoms

Traumatic brain injury arises from an impact to the head, such as being hit during a boxing match, slammed to the ground or tackled during football, a gunshot wound, falls, or a blunt force trauma, such as being hit in the head with a solid object. The symptoms of a traumatic brain injury can appear right after the injury occurred in some people, while in others, symptoms may not appear for days or weeks.

Mild TBI Symptoms

Patients suffering from a mild traumatic brain injury may black out for a few seconds or minutes or just suffer from confusion. Dizziness, nausea, vomiting, and disrupted sleep can also occur from a blow to the head. Patients might also experience some sensory symptoms, where their senses aren't interpreting signals from the environment correctly, since the brain is important for processing sensory information. Some examples of sensory symptoms are sensitivity to light or sound, ringing in the ears, or tasting something bad, even without a stimulus. Cognitive symptoms, where thinking is disrupted, like forgetfulness or unregulated emotional responses, can also occur.

Severe TBI Symptoms

Severe TBIs have proportionally severe symptoms. Patients with a severe TBI black out from minutes to hours and have repeated vomiting. They can even suffer from seizures and numbness in the body if the injury is bad enough. They also usually have dilated pupils, even in a well-lit room. Patients also might have cognitive symptoms like extreme confusion, slurred speech, or extreme emotional outbursts. Your brain controls everything in your body, so a severe injury has many serious repercussions.

Types of Traumatic Brain Injury

There are two main types of traumatic brain injury, open and closed. In an open traumatic brain injury, the skull is cracked open, broken, or penetrated. Examples of open TBI include a bullet wound or a blunt force trauma so severe the skull cracks. Some injuries can result in an object completely penetrating the skull to the other side. Some patients may survive such an event, but there will be extensive brain damage, which depends on what part of the brain was injured.

A skull fracture is a type of open traumatic brain injury
skull fracture

Closed traumatic brain injury occurs when there is an impact to the head, but the skull remains intact. A concussion is a mild type of traumatic brain injury, usually a closed traumatic brain injury that is caused by any damage to the head. Concussions may or may not result in a loss of consciousness and sometimes can be overlooked after a head injury.

Severity of traumatic brain injuries
concussion severity

However, repeat concussions can cause a permanent degenerative disorder called chronic traumatic encephalopathy, where the brain breaks down over time. Since athletes in sports like football and hockey are prone to multiple concussions, this type of TBI has been a focus lately.

A serious bruising of the brain that causes internal bleeding is called a contusion. Contusions can be caused by open TBIs, like a skull fracture, or a slamming of the skull in a closed TBI, like hitting the window during a car crash. Sometimes the brain actually slams into the opposite side of the skull and bruises that side, as well. This is called a contrecoup injury.

Contrecoup injury
contrecoup injury

A diffuse axonal injury occurs when the head is vigorously shaken or whipped around, such as in shaken baby syndrome. This can also occur during whiplash, like in a car crash. Brain structures rip apart during the force and can cause permanent brain damage, coma, or death.

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