Traumatic Brain Injury - Classification and Complications

What Is Traumatic Brain Injury?

Traumatic brain injury is a condition in which the brain is damaged due to an external force, such as a fall, a car crash, a blow to the head, a bullet, or an explosion. It impacts the neurological, economic, and social aspects of the affected individuals causing permanent disability in some individuals.

What Are the Causes of Traumatic Brain Injury (TBI)?

1. Motor vehicle accident.

2. Sudden impactful falls.

3. Assault.

4. Brain injury can occur due to shaken baby syndrome. It is a form of abusive head trauma and occurs due to violently shaking the hands and legs of the baby.

What Are the Symptoms of Traumatic Brain Injury (TBI)?

• The patient usually experiences constant headaches or pressure on the head.

• The behavior of the patient changes, and abnormalities like clumsy movements, forgetfulness, and slow response are seen.

• Loss of consciousness.

• Patients cannot recall events prior to the accident or event that caused traumatic brain injury (TBI).

• Nausea and vomiting.

• Affected individuals have balance problems and dizziness.

• The patient appears dazed or stunned.

• Complains of blurry vision.

• Have extreme sensitivity to light and touch.

• There will be confusion and mood changes in the affected individuals.

What Are the Classifications of Traumatic Brain Injury?

A. Based on the Type of Injury: Traumatic brain injury is classified into open and closed based on the type of injury.

1. Open Brain Injury: In this type of injury, the tissue of the brain is penetrated by a bullet or the bone after a fall, and the skull is broken open.

2. Closed Brain Injury: In this type of injury, penetration of the brain tissue is not seen, but there can be severe brain damage. It can lead to bleeding of the brain internally and cause swelling. This type of injury is severe compared to the closed one because the bleeding and clotting cannot go away since the skull is intact. In addition, healing of the brain does not take place on short notice in this type of injury.

B. Based on the Severity: Based on the severity of symptoms, it is divided into mild, moderate, and severe forms.

1. Mild Traumatic Brain Injury (TBI): Mild traumatic brain injury (TBI) can also be called a concussion. It usually results from blunt trauma and symptoms that are short lasting. The symptoms include nausea, vomiting, poor concentration, irritability, and loss of consciousness. The symptoms usually resolve within a week, or in concussive patients, it can take up to 12 weeks.

2. Moderate Traumatic Brain Injury (TBI): Moderate traumatic brain injury (TBI) can have prolonged levels of unconsciousness lasting up to 30 minutes to one day. There will be an altered mental state for more than a day, and the forgetfulness can last even up to a week.

3. Severe Traumatic Brain Injury (TBI): Severe forms of traumatic brain injury (TBI) can have abnormal brain imaging, and the symptoms usually last for weeks to months. The forgetfulness and altered mental state can last more than a week and need to be intervened by a medical professional.

What Happens After a Traumatic Brain Injury (TBI)?

Traumatic brain injury can cause adverse effects on the injured. It can lead to the following:

• It can lead to cognitive defects like impaired memory and attention.

• Motor disabilities like loss of balance and coordination can occur.

• Weakness of the extremities can be seen.

• Loss of sensations like touch, perception, sight, and hearing sense.

• The patient also experiences psychological stress and anxiety after a traumatic brain injury (TBI).

• There can be personality changes and aggression in some patients.

• Loss of consciousness in mild to moderate cases. In cases of severe injuries, the patient will go into a permanent state of unconsciousness, a coma.

• Immediately after a fall or event, the individual finds difficulty in breathing.

What Are the Complications of Traumatic Brain Injury?

1. Post-traumatic Amnesia: The affected individual is in a state of confusion and feels disoriented and unable to remember the events prior to the fall.

2. Coma: The unconscious state can be prolonged, and it might become difficult to wake the patient. The patient may enter into a vegetative state or coma after a few days.

3. Post-traumatic Hydrocephalus: It is also one of the serious complications of brain injury. It is characterized by an enlargement in the brain due to fluid build-up, and it can increase the intracranial pressure leading to permanent brain damage.

4. Post-concussion Syndrome: Patients who have symptoms for more than three months after traumatic brain injury (TBI) are diagnosed with post-concussive syndrome.

5. Cognitive Decline: Patients find it difficult to concentrate and reason. They also tend to develop speech difficulties, and problem-solving capability is lost. In addition, some individuals tend to lose self-awareness.

6. Chronic Traumatic Encephalopathy: In sports athletes and veterans, mild traumatic brain injury (TBI) has been associated with chronic traumatic encephalopathy. Chronic traumatic encephalopathy is a condition in which brain damage occurs due to repeated blows, and the patients have symptoms like memory loss, aggression, depression, and suicidal thoughts.

7. Punch Drunk Syndrome: In boxers, chronic blows to the head have caused a neurologic condition called ‘punch drunk syndrome.’ It is a condition caused due to repeated head injuries that can lead to loss of balance, impaired gait, and tremors in hand. It is also seen in alcoholics.

8. Post-traumatic Seizures: Patients usually develop fits or seizures that are mild a few days after the event. If it is persistent over a period of time, then it is called a post-traumatic seizure.

9. Post-traumatic Headache: Headaches are present immediately after the event and can last up to seven days. These are considered acute headaches and can last up to three months.

10. Spasticity: Muscles become stiff, and there will be uncontrolled movements of the extremities. In some patients, there can be a loss of sensation in specific muscles after a traumatic brain injury (TBI).

11. Genitourinary Complications: Voiding disorders such as incontinence and urinary retention are seen in the affected individuals. These can, in turn, lead to urinary tract infections and the development of stones in the bladder or even renal failure.

12. Gastrointestinal Complications: Feeding is compromised in brain-injured patients, and gastrointestinal problems like ulcers can develop. Delayed gastric emptying and vomiting can be seen in the affected individuals.

13. Gait Abnormalities: Trauma to the brain can cause loss of balance, and the individual finds it challenging to maintain balance during walking.

14. Psychological Problems: The affected individuals are aggressive and have irritability most of the time. Mood changes and personality changes are very significant after traumatic brain injury. In some patients, it can lead to neurosis and psychosis. Neurosis is a stress and anxiety-related condition, while psychosis involves delusional disturbances and hallucinations.

Conclusion:

It is crucial to seek the help of a doctor immediately after a fall or blow to the head that causes any of the symptoms mentioned. Children have to be supervised, and measures must be taken to prevent falls. For the elderly population, to avoid falls, certain assisting aids can be given, and always keeping them under supervision is best. Traumatic brain injury can cause symptoms that can vary from mild to severe, but it cannot be taken lightly. Seeking immediate medical care is the very first thing to do after a catastrophic event.