What Is TBI: Understanding How It Affects the Brain and Recovery Process
Traumatic brain injuries are the leading cause of death and disability for children and adults in the United States. Every year, 1.5 million people in the United States develop a traumatic brain injury.
But, what is TBI, and what happens to the brain from a TBI? Keep reading to learn all about it.
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What Is TBI (Traumatic Brain Injury)?
A traumatic brain injury (TBI) is a condition in which the brain takes damage after an external force hits the head. Each TBI comes from the pressure of external forces like car accidents, gunshots, or a fall. They don't come from internal forces like strokes and tumors.
Traumatic brain injuries may cause short-term or long-term problems with brain function. Someone with a TBI may experience issues with thinking, understanding, moving, communicating, and more.
If a traumatic brain injury is severe, it can lead to permanent disabilities or death.
There are primary and secondary TBIs. Primary TBIs happen when there is immediate damage. Secondary TBIs happen when there is slow damage over time.
Other than the timing related to brain dysfunction, there are two kinds of traumatic brain injuries:
- Penetrating TBIs (also known as open TBIs) happen when an object pierces the skull and goes into the tissue of the brain, usually damaging only one part of the brain
- Non-penetrating TBIs (also known as closed-head injuries or blunt TBIs) happen when an external force moves the brain within the skull
Patients can have one kind of TBI or both. It depends on how they develop their TBI and what happened to cause it.
Understanding TBI Signs and Symptoms
If you hit your head, but didn't seek healthcare afterward, there are a few signs to look out for. Traumatic brain injuries can affect physical and cognitive health, perception, and sensation.
Physical symptoms include the following:
- Nausea and vomiting
- Blurry vision
- Double vision
- Unequal pupil size
- Lack of appropriate pupil dilation
- Drainage of clear fluids from the nose or ears
- Evidence of a neurological deficit such as slurred speech, extremity weakness, and loss of balance
Evidence of any of these physical symptoms after a brain injury means you need to be evaluated in the emergency room. You could have severe damage to your brain, and you'll likely require medical attention.
Here are some cognitive changes you may notice with TBIs:
- Loss of or change in consciousness
- Trouble thinking
- Memory problems
- Poor decision making
- Changes in sleep patterns, including difficulty falling or staying asleep, sleeping more than usual, or not being able to be awoken from sleep
Cognitive changes can be harder to sense. If anything seems a little off, you should get evaluated just to be safe.
Lastly, there may be some perception changes you need to consider:
- Sensitivity to light or sound
- Mood swings
- Agitation and combativeness
- Loss of balance
- Poor coordination
- Hearing problems, including ringing in the ears
Again, you should go to the emergency room if you're experiencing any of these symptoms. If you don't get the treatment you need, you may experience irreversible changes.
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How to Measure the Severity of Traumatic Brain Injuries
The severity of a traumatic brain injury can tell you how much damage there is to the brain tissue. We can estimate this amount of damage by looking at four components:
- The presence of loss of consciousness and the duration during which it happened
- The presence and depth of coma
- The level of memory loss the patient experiences
- Brain scans, such as CTs and MRIs
Some of these measurements may seem subjective, but there are objective scales to remedy that.
For example, healthcare professionals use the Glasglow Coma Scale (GCS) to measure the depth of a coma, the second criterion. The GCS looks at three aspects of brain function:
- Verbal Response
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Those in a deep coma will score lower on the scale, while those who recovered from or never endured a coma will score higher.
A score of three is the lowest you can get (one point for each aspect of brain function). This number represents someone who is completely unresponsive.
A score of nine or greater tells us that the patient is no longer in a coma but not yet fully alert.
The highest score is fifteen (five points for each aspect of brain function). This tells us that the individual is fully conscious.
To determine the full course of a patient, healthcare professionals assess their GCS score multiple times. This can help us determine whether they're getting worse, getting better, or not changing.
What Happens to the Brain from a TBI?
Brain injuries like TBIs occur because of the instability of the brain. Our skulls can protect it from damage in most cases, but the damage can be too much sometimes.
Even if there isn't blunt trauma through the skull into the brain, there can be tissue damage from the sheer force.
Remember, the brain floats in cerebrospinal fluid. It's not attached to anything but to the spine via the brain stem. Although our skull keeps the brain encased, there can still be problems.
Forceful movements can cause compression, squeezing, pulling, and stretching of the brain tissue. These are the movements that cause damage to the tissue, which damages the brain's processes.
The brain responds to TBIs in a couple of different ways after incurring this damage:
- Increasing intracranial pressure from an influx of fluid with swelling, which is the body's way of padding the brain to protect it from further damage
- Cessation of neurochemical communication in an effort to heal the most pertinent parts of the brain
- The plasticity of neurons helps the brain change in response to harmful stimuli
Each one of these mechanisms serves to help the brain and body survive any further impact they may sustain. However, there are negative consequences as well.
For example, increased intracranial pressure can further damage the brain.
If your intracranial pressure becomes too high, it may cause more pressure on the brain over time. Along with brain swelling, a greater amount of fluid can cause greater injury. This is why controlling intracranial pressure is one of the first modes of action when caring for a patient with this condition.
How Are Traumatic Brain Injuries Treated?
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The treatment a patient receives for a TBI depends on the size, severity, and location of the injury. Further, these factors can also help us predict how likely the person is to recover.
Mild TBIs may not require much more treatment than some rest and pain medication. These treatments focus on relieving symptoms and resting the brain.
Your physician may also add anticonvulsants, anticoagulants, diuretics, stimulants, antidepressants, or anti-anxiety medications to help prevent further complications.
As you're undergoing this kind of treatment, you should take things easy. Any further injury could turn a mild case into a serious one. So, you should report any new or worsening symptoms to your provider.
Preventing future injury is the number one way to protect the brain.
You'll be able to return to normal activities slowly over time. But, your physician may advise that you stop all dangerous activities, including sports like football.
Treatment of severe TBIs focuses on preventing death. While that may sound abrupt, it's the truth.
Healthcare providers provide many treatments to ensure neurological stability, proper respiratory and cardiovascular function, controlled blood pressure, and good oxygen delivery. With this, they're working on preventing further brain damage by implementing safety measures.
These patients may require surgical treatment to relieve pressure from the brain, remove hematomas, or repair skull fractures. Further, they're at risk for infections and blood clots, leading to more complicated treatment.
As patients stabilize, healthcare workers begin trying to minimize the long-term effects of traumatic brain injuries.
Are TBIs Permanent?
The length of time that TBI symptoms last will depend on the kind of TBI you had and the characteristics of the TBI itself. Additionally, the amount of time you wait to get care from a physician can play a role in the long-term consequences of TBIs.
Overall, most people can get away from traumatic brain injuries with little to no residual symptoms.
However, patients with severe TBIs may experience effects for the rest of their lives. They may have trouble sleeping, eating, moving, or caring for themselves.
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These patients can get cognitive rehabilitation therapy to help them regain normal brain function. But, this doesn't guarantee that you'll go back to normal.
You may start regaining function over time, though.
Track Your Traumatic Brain Injury Symptoms
So, what is TBI? Well, a TBI (traumatic brain injury) is a potentially life-threatening condition that causes damage to the brain in one way or another. If you've experienced a TBI, you'll need medical attention quickly to ensure that there aren't any lasting effects from the trauma.
Further, you'll need to pay attention to any new or worsening symptoms over time.
If you need to track TBI symptoms, Power of Patients can help. Check out our symptom-tracking application to help you track everything you and your provider need during your treatment.