Traumatic brain injury
DEFINITION
Traumatic brain injury occurs when an external mechanical force causes brain dysfunction.
Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.
Mild traumatic brain injury may cause temporary dysfunction of brain cells. More serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain that can result in long-term complications or death.
CAUSES
Traumatic brain injury is caused by a blow or other traumatic injury to the head or body. The degree of damage can depend on several factors, including the nature of the event and the force of impact.
Injury may include one or more of the following factors:
- Damage to brain cells may be limited to the area directly below the point of impact on the skull.
- A severe blow or jolt can cause multiple points of damage because the brain may move back and forth in the skull.
- A severe rotational or spinning jolt can cause the tearing of cellular structures.
- A blast, as from an explosive device, can cause widespread damage.
- An object penetrating the skull can cause severe, irreparable damage to brain cells, blood vessels and protective tissues around the brain.
- Bleeding in or around the brain, swelling, and blood clots can disrupt the oxygen supply to the brain and cause wider damage.
Common events causing traumatic brain injury include the following:
- Falls. Falling out of bed, slipping in the bath, falling down steps, falling from ladders and related falls are the most common cause of traumatic brain injury overall, particularly in older adults and young children.
- Vehicle-related collisions. Collisions involving cars, motorcycles or bicycles — and pedestrians involved in such accidents — are a common cause of traumatic brain injury.
- Violence. About 20 percent of traumatic brain injuries are caused by violence, such as gunshot wounds, domestic violence or child abuse. Shaken baby syndrome is traumatic brain injury caused by the violent shaking of an infant that damages brain cells.
- Sports injuries. Traumatic brain injuries may be caused by injuries from a number of sports, including soccer, boxing, football, baseball, lacrosse, skateboarding, hockey, and other high-impact or extreme sports, particularly in youth.
- Explosive blasts and other combat injuries. Explosive blasts are a common cause of traumatic brain injury in active-duty military personnel. Although the mechanism of damage isn’t yet well-understood, many researchers believe that the pressure wave passing through the brain significantly disrupts brain function.
SYMPTOMS
Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.
Mild traumatic brain injury
The signs and symptoms of mild traumatic brain injury may include:
Physical symptoms
- Loss of consciousness for a few seconds to a few minutes
- No loss of consciousness, but a state of being dazed, confused or disoriented
- Headache
- Nausea or vomiting
- Fatigue or drowsiness
- Difficulty sleeping
- Sleeping more than usual
- Dizziness or loss of balance
Sensory symptoms
- Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell
- Sensitivity to light or sound
Cognitive or mental symptoms
- Memory or concentration problems
- Mood changes or mood swings
- Feeling depressed or anxious
Moderate to severe traumatic brain injuries
Moderate to severe traumatic brain injuries can include any of the signs and symptoms of mild injury, as well as the following symptoms that may appear within the first hours to days after a head injury:
Physical symptoms
- Loss of consciousness from several minutes to hours
- Persistent headache or headache that worsens
- Repeated vomiting or nausea
- Convulsions or seizures
- Dilation of one or both pupils of the eyes
- Clear fluids draining from the nose or ears
- Inability to awaken from sleep
- Weakness or numbness in fingers and toes
- Loss of coordination
Cognitive or mental symptoms
- Profound confusion
- Agitation, combativeness or other unusual behavior
- Slurred speech
- Coma and other disorders of consciousness
Children’s symptoms
Infants and young children with brain injuries may lack the communication skills to report headaches, sensory problems, confusion and similar symptoms. In a child with traumatic brain injury, you may observe:
- Change in eating or nursing habits
- Persistent crying and inability to be consoled
- Unusual or easy irritability
- Change in ability to pay attention
- Change in sleep habits
- Sad or depressed mood
- Loss of interest in favorite toys or activities
When to see a doctor
Always see your doctor if you or your child has received a blow to the head or body that concerns you or causes behavioral changes. Seek emergency medical care if there are any signs or symptoms of traumatic brain injury following a recent blow or other traumatic injury to the head.
The terms “mild,” “moderate” and “severe” are used to describe the effect of the injury on brain function. A mild injury to the brain is still a serious injury that requires prompt attention and an accurate diagnosis.
