What is Brain Injury?

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What is the meaning of Brain Injury?

Brain injury is a non-degenerative and non-congenital injury to the brain tissue due to external forces like trauma ( e.g. accidents, etc. ) where a person’s brain can get severely damaged (either permanent or temporary damage).  

The cognitive, physical, emotional, and psychological functions of the brain are affected. Patients may experience reduced or altered states of equilibrium and consciousness. 

Brain injury may also occur due to excessive use of alcohol and drugs, brain infection, sudden violent behavior, etc. 

Doctors may perform a CT scan and an MRI scan to find out the cause of brain injury. Patients with a brain injury require immediate hospitalization to get proper and timely treatment. Severe cases of brain injury may require surgery, while a mild brain injury can cure on its own. Sometimes a severe brain injury may also result in the death of the person. 

Let us tell you in detail about Brain Injury through this article: 

• What are the types of Brain Injury?
• What are the causes of Brain Injury? 
• What are the symptoms of Brain Injury? 
• How to diagnose Brain Injury?
• What are the treatments for Brain Injury? 
• What are the rehabilitation methods after Brain Injury?
• How to prevent Brain Injury?

What are the types of Brain Injury?

The two types of brain injuries-

Traumatic Brain Injuries– These are the most widely occurring brain injuries caused due to road traffic accidents, falls, physical assaults or sport related head injuries or any external source of head injuries. Following are the types of traumatic brain injuries-

• Concussion (happens when the injury happens due to brain hitting the internal walls of the skull)
• Edema (this is the swelling of the brain tissue due to any trauma to the brain, since skull does not expand due to swelling so edema causes pressure on the brain tissue)
• Diffuse Axonal injury ( where the axons of the brain cells get damaged and do not function properly, leading to loss of brain functions )
• Hematoma ( this is the condition where blood pools in the brain or in the empty spaces around the brain due to ruptured blood vessels )
• Skull fractures ( they can cause brain injury by causing brain infections, change in brain functions, can also lead to Cerebrospinal fluid leakage requiring brain surgery )

Non- traumatic/ Acquired Brain Injuries- These are the brain injuries caused due to internal factors like stroke, aneurysm, pressure by the brain tumor, lack of oxygen, drowning incident, toxin exposure or infections of the brain. Following are the types of non- traumatic brain injuries-

• Hemorrhage ( this is the uncontrollable bleeding that may occur either in the brain tissue or in the space around the brain tissue, mostly occurs due to brain aneurysm bursting and is a life- threatening condition )
• Hypoxic brain injury (this occurs due to shortage or complete absence of oxygen to the brain or part of the brain, that affects the breathing patterns )
• Stroke (this happens when the blood supply to the brain is completely stopped due to artery blockage or hemorrhage, this can also occur due to temporary clot formation)

( Know more about- What is the difference between Brain Stroke and Heart Attack? )

What are the causes of Brain Injury?

Causes of Traumatic brain injuries: Trauma to the brain tissue can occur in following cases-

• Road traffic accidents
• Head blow accidents by hitting against objects
• Sport injuries
• Physical assault or violence injuries
• Fall injuries

Causes of Non- traumatic brain injuries are: 

• Drug abuse
• Alcohol abuse
• Neurological illnesses ( eg. Parkinson’s disease, etc )
• Brain aneurysms
• Heart attacks
• Brain tumors
• Brain stroke
• Lack of oxygen to brain due to strangulation, choking or drowning episodes
• Brain infections ( eg. meningitis, etc )
• Toxin exposures
• Poisoning 

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What are the symptoms of Brain Injury? 

The symptoms of a brain injury can be classified into- Cognitive, Perceptual, Physical and Behavioral/Emotional , 4 categories. 

Physical symptoms of brain injury are-

• Loss of consciousness
• Speech alterations of slurred speech
• Sleep alterations and disorders
• Photosensitivity or light sensitivity
• Seizures
• Fatigue or weakness
• Tremors 
• Paralysis ( half body or full body )
• Mental fatigue or tiredness
• Chronic persistent headaches

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Behavioral or emotional symptoms of brain injury are-

• Aggressiveness ( increased )
• Denial state of attitude
• Heightened or negligible emotions
• Reduced stress tolerance
• Increased irritability
• Increased levels of impatience

Perceptual symptoms of brain injuries-

• Increased sensitivity to pain
• Smell and taste disorders
• Equilibrium or balance related disorders
• Loss of time track
• Disorientation to the environment
• Vision loss, hearing loss or loss of sense of smell

Cognitive symptoms of brain injuries- 

• Memory loss
• Ability of decision making is lost or impaired
• Lack of understanding of abstract thoughts
• Attention deficit or attention span is shortened
• Difficulty in expressing thought, understanding others or information processing

(Know more about-What is Alzheimer’s Disease? Causes, Symptoms, Treatment, Prevention )

How to diagnose Brain Injury?

After the initial physical examination, the patient or the patient party ( friends or family ) are asked the following questions to assess the degree of brain injury-

• Cause of brain injury
• Did the person lose consciousness and for how long
• Other signs of brain injury like- degree of alertness, body coordination or slurred speech, etc, was observed
• Was head struck against some object and what object if yes
• Force of the injury or the impact ( like what hit the person’s head or how far did the person fall from vehicle or was he/she on vehicle when injury happened)
• Degree of injury to other parts of body

After the initial physical examination , medical history and history of the trauma is asked, patient is immediately sent for the following imaging tests-

• CT Scans- This is performed in the trauma care centre immediately incase of traumatic brain injury to get detailed views of the brain damage, fractures, internal bleeding, clots, bruised brain tissue or contusions, or edema (swelling).
• MRI Scans- This also gives a detailed view of the brain, usually done after the condition of the patient stabilizes to detect any further abnormality.
• Intracranial pressure monitor-  A probe is inserted into the skull to check and monitor the intracranial pressure, where brain injury is due to trauma and there is swelling in the brain. 
• Glasgow coma scale- In this test, the patient’s ability to follow directions and eye and limb movements, speech,etc.  are analysed, following which a number is given on a scale of 15 pointer. Higher score means less severe injury.

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What are the treatments for Brain Injury?

The treatment of brain injury depends on the cause and how severe the injury is.

Following are the treatment methods for the various types of brain injuries-

For patients with mild brain injury- 

• The doctor may advise rest and pain medications for headache and other symptoms. Patients should be monitored closely for increase in pain, or worsening of old symptoms or for new symptoms. One must consult a doctor immediately in case symptoms become severe, without any delay.
• Doctors shall advise to rest for a few days during which a person must limit physical and mental ( cognitive ) activities. Following this patients are advised to gradually resume back their work ( school, daily routines, office, recreational activities, etc ).

Emergency care for moderate to severe brain injury patients-

• In such cases, the hospital team focuses on adequate oxygen and blood supply to the brain, maintaining vitals ( blood pressure, breathing rate, heart rate ), preventing any further blood loss (internal or external), managing the fractures or infections, if any, and preventing any further brain damage.
• If any other physical injury due to trauma is there, it is managed and treated in the ICU. 

Medications- Following medications may be provided to prevent any secondary damage to the brain tissue after brain injury-

• Anti-seizure drugs (to prevent secondary damage to the brain due to seizure attacks that are seen in patients with brain injury in the first week )
• Diuretics ( to increase the urine output that reduces the amount of fluid accumulated in and around the brain tissues, reducing swelling and pressure on injured brain )
• Coma-inducing drugs ( to put the patient in temporary comatose state, as comatose brain needs less oxygen supply to function, especially if there is damage to the brain’s blood vessels, etc )

Surgery- The following types of emergency surgeries may be carried out to prevent secondary damage to the brain, after brain injury-

• Surgery to remove hematomas ( as collected and clotted blood may put pressure on the brain tissue )
• Skull repair surgery in case of skull bone fractures ( to remove pieces of fractured bone that may cause further brain damage )
• Surgery to stop bleeding or hemorrhage
• Surgery to make a window or opening in the skull ( this is done to make opening for the leaking CSF or to make space for the swollen brain tissue, to prevent secondary pressure and damage to brain tissue )

( Know more about- What is Brain Aneurysm Surgery? Causes, Tests, Procedure, Cost )

What are the rehabilitation methods after Brain Injury?

After brain injury and treatment for the same, many patients might need rehabilitation. This is done to improve their day-to-day life activities like walking, talking, etc. The rehabilitation therapy usually begins in the hospital and continues in the rehabilitation center.

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Duration and type of rehabilitation depend on the type and severity of the brain injury. It requires a team of specialists which are-

• Psychiatrist
• Occupational therapist
• Physical therapist
• Speech and language therapist
• Vocational counselor
• Neuropsychologist

Apart from this, patients might also need social worker support, recreational therapists, and nurses. 

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How to prevent Brain Injury? 

Following steps and methods can help prevent brain injury-

• Avoid overconsumption of alcohol
• Never drink and drive
• Do not take illegal drugs
• Be cautious while walking down the staircase, especially aged people. One should have a stable rail by the staircase and take support while walking down the stairs
• Guns if kept in the house, should be kept away from kids and unloaded
• Avoid head injuries caused to falls, be careful while walking 
• Drive carefully, within speed limits, and always wear seat belts
• Wear helmets ( rider and pillion rider ) while driving two-wheelers or sports vehicles
• Sports injuries must be avoided by wearing helmets, Q collars, Headgears, etc
• Playgrounds must have shock-absorbing materials
• Care must be taken to prevent head injuries in children by babyproofing houses, window guards, and child locks in the car windows to prevent them from falling, etc. 
• Underlying medical conditions like heart-related problems must be monitored and treated to avoid brain injuries.

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We hope we were able to answer your queries about Brain Injury through this article.

If you want more information and treatment of Brain Injury, then contact a Neurologist. 

We only aim to give you the information in this article. We do not recommend any medication, treatment, or surgery. Only a doctor can give you the best advice and correct treatment plan. 

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