Traumatic brain injury overview: Difference between revisions
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==Causes== | ==Causes== | ||
* | *Common causes of traumatic brain injury include [[falling|falls]] and [[Motor vehicle accident]] | ||
==Differentiating Traumatic Brain Injury from other Diseases== | ==Differentiating Traumatic Brain Injury from other Diseases== | ||
Revision as of 19:59, 31 August 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Joanna Ekabua, M.D. [2]
Overview
Traumatic brain injury (TBI) occurs when physical trauma causes brain damage. TBI can result from a closed head injury or a penetrating head injury and is one of two subsets of acquired brain injury (ABI). The other subset is non-traumatic brain injury, or injuries that do not involve external mechanical force (e.g. stroke, meningitis, anoxia). Parts of the brain that can be damaged include the cerebral hemispheres, cerebellum, and brain stem.
TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. TBI can cause a host of physical, cognitive, emotional, and social effects. Outcome can be anything from complete recovery to permanent disability or death.
Historical perspective
- There is limited knowledge on the historical perspective of traumatic brain injury.
Classification
- Traumatic brain injury may be classified as either
- Focal vs. diffuse
- Open vs. closed
- Mild, moderate or severe
Pathophysiology
- The progression of traumatic brain injury usually involves the inflammatory response pathway.
- Unlike most forms of traumatic death, a large percentage of the people killed by brain trauma do not die right away but rather days to weeks after the event. Rather than improving after being hospitalized, some 40% of TBI patients deteriorate. Primary injury (the damage that occurs at the moment of trauma when tissues and blood vessels are stretched, compressed, and torn) is not adequate to explain this degeneration. Rather, the deterioration is caused by secondary injury, a complex set of biochemical cascades that occur in the minutes to days following the trauma and contribute a large amount to morbidity and mortality from TBI.
- Secondary injury events are poorly understood but are thought to include brain swelling, alterations in cerebral blood flow, a decrease in the tissues' pH, free radical overload, and excitotoxicity. These secondary processes damage neurons that were not directly harmed by the primary injury.
Causes
- Common causes of traumatic brain injury include falls and Motor vehicle accident
Differentiating Traumatic Brain Injury from other Diseases
Epidemiology and Demographics
Risk factors
Natural History, Complications and Prognosis
Natural history
Complications
The results of traumatic brain injury vary widely in type and duration. A head injured patient may experience physical effects of the trauma such as headaches, movement disorders (e.g. Parkinsonism), seizures, difficulty walking, sexual dysfunction, lethargy, or coma. Cognitive symptoms include changes in judgment or ability to reason or plan, memory problems, and loss of mathematical ability. Emotional problems include mood swings, poor impulse control, agitation, low frustration threshold, self-centeredness, clinical depression, and psychotic symptoms such as hallucinations and delusions.
Prognosis
Traumatic brain injury is a frequent cause of major long-term disability in individuals surviving head injuries sustained in war zones. This is becoming an issue of growing concern in modern warfare, in which rapid deployment of acute interventions is effective in saving the lives of combatants with significant head injuries. Traumatic brain injury has been identified as the "signature injury" among wounded soldiers of the current military engagement in Iraq.
Diagnosis
History and Symptoms
Physical Examination
Head injured people with signs of moderate or severe TBI should receive immediate emergency medical attention.