Traumatic Brain Injury

Your brain's reaction to an injury is similar to an ankle bruising and swelling after a bad fall. Even though a minor TBI like a concussion may heal with rest and time, it is best to seek medical care. More severe injuries require advanced and specialized neuro-critical care.

Types of TBIs 

There are several ways to categorize traumatic brain injuries.

• Mild, moderate, and severe: Doctors use these terms to describe the injury based upon initial signs and symptoms, like headache, fatigue, dizziness, speech problems, sensory changes, loss of consciousness, and confusion.
• Open vs. closed: This distinction is based on whether the injury punctures the skull.
• Primary vs. secondary:
  • Primary injury refers to the initial trauma itself.
  • Secondary injury refers to how your body responds to the trauma, mainly with swelling. Because the brain sits inside the rigid space of your skull, too much swelling can choke off the brain’s supply of blood and oxygen.

Before we treat the primary injury, we use tests to determine its severity as quickly as possible. 

Clinical Evaluation

A clinical evaluation includes a physical exam and a neurological exam to assess your mental status as well as language, nerve, motor, sensory, and reflex functions.

Glasgow Coma Scale

Doctors assess your level of consciousness and how well you respond to requests to open your eyes, speak, and move certain parts of your body. Higher scores indicate higher function and usually correspond with better outcomes.

Imaging Scans

CT or MRI scans help your doctors see the internal structure of your head, neck, and spine. You may also need a CT angiogram, which is a CT scan that uses injected dye to highlight blood vessels.

EEG Monitoring

Through electrodes placed on your scalp, an electroencephalogram (EEG) painlessly monitors and records brain waves.

Intracranial Pressure (ICP) Monitoring

ICP monitors use a small probe inserted through the skull to measure cerebrospinal fluid (CSF) and brain swelling.

The goals of primary TBI treatment are to stabilize the patient and prevent a secondary traumatic brain injury by controlling intracranial pressure. 

Medications 

These can help reduce swelling, prevent seizures, and relieve pain.

Surgery 

Severe and sometimes moderate TBIs may require surgery to remove blood clots, create more space for brain swelling, treat skull or facial fractures, and more.