The recent tragic death of actress Natasha Richardson after a seemingly minor fall on a beginner’s ski slope has heightened attention to Traumatic Brain Injuries (TBIs) and the importance of immediate treatment for head injuries in order to decrease the risk of death or permanent brain damage.
Of the 1.4 million people annually who sustain a Traumatic Brain Injury in the United States, 50,000 of those people die, 235,000 are hospitalized, and 1.1 million are treated and released from an emergency department. Among children ages 0 to 14 years, Traumatic Brain Injury results in an estimated 2,685 deaths, 37,000 hospitalizations, and 435,000 emergency department visits annually.
What is Traumatic Brain Injury?
According to the Centers for Disease Control and Prevention, Traumatic Brain Injury is caused by sudden bumps, blows or jolts to the head or a penetrating head injury that disrupts the normal function of the brain,. Such an injury can bruise the brain, tear nerve fibers and cause bleeding. The severity of a Traumatic Brain Injury may range from “mild,” i.e., a brief disruption in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.
What are the signs and symptoms of Traumatic Brain Injury?
The signs and symptoms of a Traumatic Brain Injury (TBI) can be subtle. Symptoms of a TBI may not appear until sometime following the injury or may even be missed as victims may appear unaffected by their injury.
Symptoms of mild TBIs may include:
- Brief period of unconsciousness;
- Dizziness/loss of balance;
- Blurred vision/tired eyes;
- Ringing in ears;
- Change in sleep patterns; and
- Behavioral/mood changes.
Symptoms of moderate to severe TBIs include the same symptoms as mild TBIs, as well as:
- Headache that gets worse;
- Vomiting or nausea;
- Convulsions or seizures;
- Inability to awaken from sleep;
- Dilated pupils;
- Slurred speech;
- Weakness/numbness of extremities;
- Loss of coordination; and
- Increased confusion, restlessness, agitation.
What are the long-term outcomes of a Traumatic Brain Injury?
Long-term consequences of Traumatic Brain Injuries (TBIs) may include (but are not limited to) the following:
- Confusion or distraction;
- Trouble with planning, organizing, problem solving, abstract reasoning, making judgments ;
- Memory issues;
- Sensory problems, especially with vision;
- Difficulty with hand-eye coordination;
- Difficulty driving, operating machinery, playing sports;
- Communication problems;
- Emotional/behavioral problems; and
- Increased risk for epilepsy, Parkinson’s Disease, Alzheimer’s Disease, and other disorders of the brain commonly associated with age.
What is the treatment for Traumatic Brain Injury?
According to the Mayo Clinic, mild TBIs usually require little more than rest and over-the-counter pain relievers. However, more severe injuries often require hospitalization and intensive care and only a doctor can determine the extent of the injury to the brain.
Emergency care for a Traumatic Brain Injury involves focusing on preventing the brain damage from worsening. The main problem resulting from a TBI is swelling of injured brain tissue. The pressure is enough to harm the tissue, but damage can also result if compressed blood vessels can’t supply brain cells with food and oxygen.
Medications that are used to treat TBIs include diuretics, which reduce the amount of fluid in tissue in order to reduce swelling; anti-seizure drugs to avoid additional brain damage; and coma-inducing drugs to reduce the amount of oxygen needed for the brain to function.
In some cases, surgery may be performed to remove blood clots from the brain to reduce pressure and prevent additional brain damage, or to repair fractures if a portion of the skull is putting pressure on the brain. Surgeons may also create an opening in the skull to relieve pressure and reduce swelling.
Victims of Traumatic Brain Injury may also require rehabilitation to relearn basic skills.
Can Traumatic Brain Injury be prevented?
While Traumatic Brain Injuries will continue to occur due to unavoidable accidents, the Centers for Disease Control and Prevention lists the following ways to significantly reduce the risk of TBI:
- Always wear a seatbelt when riding in a motor vehicle, and buckle young children into safety or booster seats.
- Never drive under the influence of drugs or alcohol.
- Wear a helmet when riding a bike or vehicle, playing a contact sport, using skates or a skateboard, batting or running bases, riding a horse, and skiing and snowboarding.
- Make living areas safer for the elderly (install handrails and grab bars, remove tripping hazards, etc.).
- Make living areas safer for children (install window guards to prevent falls, reduce temptations to climb, use safety gates near stairs).
- Use shock-absorbing materials for the surface of playgrounds.
Sources: Brain Injury Assocation of America, Centers for Disease Control and Prevention, Mayo Clinic, and the National Institutes of Health.