A traumatic brain injury, or TBI, can happen when there is a blow to the head. The injury can be penetrating, such as a gunshot wound, or a non-penetrating injury, such as being struck in the head in a car accident.
The severity of the head injury is determined by several different factors, such as loss of consciousness, certain neurological symptoms that happened at the time of the injury, loss of memory for the injury and time surrounding it, and abnormalities on head CT or brain MRI.
brain injury symptoms in adults
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When you take a violent, hard hit to your head, your brain may experience changes in chemical and energy use as a way to compensate for the injury. These changes can result in headaches, light/sound sensitivity, and confusion. In mild TBIs, these changes are short and do not permanently damage the brain. However, with more severe injuries, these changes can last longer and result in damage to the brain cells. These effects can cause the brain to swell and expand inside the skull. The swelling can lead to even more brain damage.
TBI symptoms vary depending on how severe the injury is. A key sign is loss of consciousness (passing out) after a blow. Some people feel dazed for a couple of minutes and others are unresponsive for long periods (coma or persistent vegetative state).
People with mild TBIs can have several different symptoms, most of which occur right after the head injury or the days following. Sometimes people do not feel the severity of a symptom until they return to school or work.
Your healthcare provider will examine you and ask about your symptoms. They will also want to learn more about what caused the injury. Depending on the severity of the injury and symptoms, you may have:
A traumatic brain injury (TBI) can be caused by a forceful bump, blow, or jolt to the head or body, or from an object that pierces the skull and enters the brain. Not all blows or jolts to the head result in a TBI.
TBI-related damage can be confined to one area of the brain, known as a focal injury, or it can occur over a more widespread area, known as a diffuse injury. The type of injury also affects how the brain is damaged.
Initial assessments may rely on standardized instruments such as the Acute Concussion Evaluation (ACE) form from the Centers for Disease Control and Prevention (CDC) or the Sport Concussion Assessment Tool 2, which provide a systematic way to assess a person who has suffered a mild TBI. Reviewers collect information about the characteristics of the injury, the presence of amnesia (loss of memory) and/or seizures, as well as the presence of physical, cognitive, emotional, and sleep-related symptoms. The ACE is also used to track symptom recovery over time. It also takes into account risk factors (including concussion, headache, and psychiatric history) that can impact how long it takes to recover from a TBI.
Diagnostic imaging. When necessary, medical providers will use brain scans to evaluate the extent of the primary brain injuries and determine if surgery will be needed to help repair any damage to the brain. The need for imaging is based on a physical examination by a doctor and a person's symptoms.
Many athletic organizations recommend establishing a baseline picture of an athlete's brain function at the beginning of each season, ideally before any head injuries occur. Baseline testing should begin as soon as a child begins a competitive sport. Brain function tests yield information about an individual's memory, attention, and ability to concentrate and solve problems. Brain function tests can be repeated at regular intervals (every one to two years) and also after a suspected concussion. The results may help healthcare providers identify any effects from an injury and allow them to make more informed decisions about whether a person is ready to return to their normal activities.
Even after symptoms resolve entirely, people should return to their daily activities gradually once they are given permission by a doctor. There is no clear timeline for a safe return to normal activities although there are guidelines such as those from the American Academy of Neurology and the American Medical Society for Sports Medicine to help determine when athletes can return to practice or competition. Further research is needed to better understand the effects of mild TBI on the brain and to determine when it is safe to resume normal activities.
Despite recent progress in understanding what happens in the brain following TBI, more than 30 large clinical trials have failed to identify specific treatments that make a dependable and measurable difference in people with TBI. A key challenge facing doctors and scientists is the fact that each person with a TBI has a unique set of circumstances based on such multiple variables as the location and severity of the injury, the person's age and overall heath, and the time between the injury and the initiation of treatment. These factors, along with differences in care across treatment centers, highlight the importance of coordinating research efforts so that the results of potential new treatments can be confidently measured.
Results: SF-36 showed impaired scores in all dimensions. Existing post-concussion symptoms were reported by 1545%. Significantly, more symptoms were present at 3 months than at 3 weeks after injury. Furthermore, a significant correlation between higher rates of post-concussion symptoms and lower SF-36 scores was found.
Conclusions: The SF-36 results were significantly impaired compared with an age- and gender-matched normative control group and the rate of post-concussion symptoms was significantly higher at 3 months than at 3 weeks after injury. As a significant correlation between higher rates of symptoms and low SF-36 scores was also found we assume SF-36 to be a sensitive enough measure of MTBI-related effects.
Dr. Seunggu Han is an ABMS board certified neurological surgeon and an associate clinical professor in the department of neurological surgery at Stanford. He currently practices in Salinas and Santa Cruz, California. His interests include surgical neuro-oncology, traumatic brain injury, and quality improvement in surgery.
A head injury is any sort of injury to your brain, skull, or scalp. This can range from a mild bump or bruise to a traumatic brain injury. Common head injuries include concussions, skull fractures, and scalp wounds. The consequences and treatments vary greatly, depending on what caused your head injury and how severe it is.
A traumatic brain injury often happens because of a direct blow to the head, but it can result from any jarring movement that causes the brain to smash into the skull. Inflammation and swelling inside the brain often damage nerves and prevent areas of the brain from receiving the oxygen and glucose it needs to perform. These effects of the injury disrupt the normal function of the brain.
A mild traumatic brain injury is commonly called a concussion. Someone with an mTBI may or may not have lost consciousness, but if they did, it was for a very short time. (In fact, less than 10% of people with a concussion lose consciousness.) There is usually no bleeding in the brain and no skull fracture.
Someone with a severe traumatic brain injury must experience an extended loss of consciousness or even be in a coma. The skull may have a serious fracture, or some object might have penetrated it. Severe TBIs often require intensive care and emergency neurosurgery:
Most people who sustain a concussion completely recover within a couple of weeks of their injury. A few, however, along with those who sustained a moderate or severe TBI, have to deal with a host of persistent symptoms indefinitely.
An injury to the brain sometimes damages neuronal connections. Inflammation and swelling in response to the injury can diminish the amount of blood traveling to or through those injured areas. This disrupts the established neurovascular coupling pathways (without resulting in cell death).
When people recover from a brain injury, those pathways will either return to normal or continue malfunctioning. If they fail to revert to healthier signaling after the trauma of the acute injury subsides, the result is long-term dysfunction of neurovascular coupling and thus long-term symptoms of TBI.
Vision problems: The communication between your eyes and your brain, along with neurovascular coupling in the regions that process visual information, can be disrupted after a brain injury. You might experience changes in your peripheral vision (seeing too much or too little), eye teaming (how the eyes work together), depth perception, focusing, and more. These changes can then cause symptoms such as headaches, tired eyes, double vision, difficulty reading, and more.
Vestibular dysfunction: The vestibular system, an organ located in your inner ears, works with your vision, body, and brain to determine your position in space, keep you balanced, and help your vision stay clear when you move. After a concussion, communication between some or all of those systems could be affected. Vestibular dysfunction can produce symptoms such as headache, dizziness or vertigo, difficulty balancing, sleep problems, spatial disorientation, and more.
An MRI uses magnets and radio waves to look at soft tissue within the brain and the body. It is best used for detecting bruises (contusion), blood clots (hematoma), minor bleeding, tumors, excessive fluid, or even signs of dementia in the brain. It is not the best scan to start with immediately after a severe head injury. It might be done after the patient is more stable.
A CT scan (computed tomography scan) uses X-ray beams and, if performed after a head injury, can detect bleeding (hemorrhage), brain swelling, and skull fractures. In an emergency situation, a CT scan is most commonly ordered to determine if a patient needs to be watched or if emergency neurosurgery is necessary. 2ff7e9595c
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