Although the brain is surrounded by three layers of protective fluid and is encased in the hard skull, it is certainly not impervious to the effects of trauma. Any number of sudden events can lead to what is known as traumatic brain injury. The most common causes are automobile accidents, assaults, and the effects of gunshots. Because of the increased violence occurring in certain athletic events, sports-related brain injuries are also happening more frequently.
A head injury can be either open or closed. In the former, the skull is penetrated by an object and the brain is pierced. Bullets, bone fragments or other projectiles that enter the brain can cause localized or even diffuse damage. Closed head injuries, although they may seem minor because no intense bleeding is involved, can be equally devastating. In these situations, the brain sustains damage by being shaken or knocked against the skull, resulting in bruising (contusion), bleeding of the brain (intracerebral hemorrhage) or bleeding into the space around the brain (subarachnoid hemorrhage). Although most head injuries are minor and their symptoms go away on their own, over half a million Americans each year suffer severe head injuries that require hospitalization. Often, the effects of these events are lasting, permanently altering a person’s behavior and ability to function independently.
These serious consequences occur when the brain is damaged because of bleeding into it or other injurious forces. Because of the serious consequences that can result from head injury, it is imperative that it be diagnosed and treated as soon as possible. Symptoms of severe head injury to look for are the following: changes in the appearance or size of the person’s pupils, distorted facial features, blood or clear fluid coming from the nose or mouth, the appearance of a fracture or scalp wound, inability to move one or more limbs, impaired sensory functioning (hearing, smell, taste, sight), irritability (particularly in children), loss of consciousness, confusion, sleepiness, drop in blood pressure or breathing, restlessness or clumsiness, slurred speech, headache, stiff neck, vomiting, or changes in level of awareness.
Once a person has sought medical attention, a series of diagnostic tests can be run. These are designed to determine the location and extent of the injury to the brain and can include cognitive tests, CT scans, and head MRI’s. After the results are compiled, medical professionals, care-givers, and the patient will form a treatment team, and will discuss how the injury has affected the brain and the steps that can be taken to minimize the consequences and compensate for any permanent loss of functioning. Each brain injury is unique and only time, care, and hard work will tell in what ways the patient’s life will be changed by this traumatic injury. Fortunately, the past few years have seen considerable advances not only in direct surgical interventions, but also in the rehabilitative techniques that can lead to increased functioning, well-being, and healing. Because of the on-going support of a multi-disciplinary team, patients are often able to implement a system of strategies and techniques designed to optimize their abilities, while minimizing the chronic effects of the traumatic event.