By Dr. RICHARD BROWNLEE
Welcome Back MRI and Pain Management Centre
TRAUMATIC BRAIN INJURY (TBI) is a major cause of death and disability worldwide. The best treatment for traumatic brain injury is prevention. Policies such as mandatory helmets and seat belts have reduced the incidence and severity of traumatic brain injury. However, they still occur far too often with devastating consequences for the person and their family.
What Causes a Traumatic Brain Injury?
Focal impact to the head
Acceleration – deceleration mechanisms, which cause the brain to move within the skull, even without a direct impact to the head.
What Are the Causes?
Motor vehicle accidents are the leading cause of traumatic brain injuries, accounting for approximately 50%.
Falls are the second leading cause of TBI accounting for 20-30%. These are most common in persons over 75 years of age and in very young children.
Assaults, sports related injuries and recreational injuries account for the remainder of traumatic brain injuries.
How Are Brain Injuries Diagnosed?
Examination of the person provides information on their level of consciousness and responsiveness, which are used to determine the severity of a traumatic brain injury. Diagnostic imaging studies, mostly commonly CT scans, provide evidence of bleeding inside the skull which can be inside the brain if there is a laceration or contusion or on the outside of the brain but inside the skull. This type of bleeding puts pressure on the brain that can cause further brain damage.
The Glasgow Coma Scale is the most widely used assessment tools for measures the severity of a brain injury within the first 48 hours of the injury.
Mild Head Injury has been defined as a traumatically induced physiological disruption of brain function as manifest by one or more of the following:
Any period of loss of consciousness (LOC).
Any loss of memory for events immediately before or after the accident.
Any alteration in mental status at the time of the accident.
Focal neurological deficits, which may or may not be transient.
Many patients with mild traumatic brain injury do not present to the hospital and those who do may be discharged from the emergency department without being recognized as having suffered a brain injury. A concussion is a form of mild traumatic brain injury. The diagnosis is based on the history and examination. CT scans and MRI scans of the brain are usually normal with no evidence of damage to the brain.
How Are Traumatic Brain Injuries Treated?
Treatment depends on the type and severity of the injury and can include:
Physiotherapy for physical problems affecting the person’s strength, balance or coordination.
Occupational Therapy helps the person and their family adapt to household, work and recreational activities that are often affected by a brain injury.
Psychological Treatment is also important for the patient and the family because of changes in personality, behaviour and cognitive function that result from brain injuries.
Providing these services in a multi-disciplinary integrated program is the most effective approach that deals with physical and emotional or psychological components of the injury simultaneously.
Did You Know?
Many people with mild traumatic brain injuries go unrecognized and untreated. Concussion in sport has raised our awareness of mild traumatic brain injuries.
Concussion Prevention Tips
Wear protective gear during sports and recreational activities. Ensure all equipment fits properly, is in good condition and worn correctly.
Replace your helmet at least every five years. Extensive use or extreme changes in temperature can cause a helmet to deteriorate faster. If a helmet is dropped or cracked, it should be replaced immediately.
Always fasten your seat belt to reduce the risk of serious injury in the event of a traffic accident. Make sure children are buckled in appropriately, according to their size and the specifications on their carseats.
Keep your home well-lit and your floors clear of items that might cause someone to trip and fall.
Block off stairways and install window guards to protect children.
Regular exercise improves balance and strengthens leg muscles.
This is one in a series of articles written for NewsKamloops.com by the Welcome Back MRI & Pain Management Centre.