Every brain injury is unique meaning that two people can suffer from the exact same injury but will both have different challenges in their recovery and each will have a different long term prognosis.
A brain injury occurs when an outside force disrupts the normal brain functions. There are many incidents which can result in a brain injury, such as a fall from height, a road traffic accident or a blow to the head. There are also many different types of injuries and these can all range in their severity.
The most important point with any type of brain injury is to ensure that the patient receives immediate medical treatment. There is a wide range of testing from MRI scans to EEG’s to help the diagnostic process. The earlier the person receives treatment the better chance there is for a good long term outcome.
Let’s break it down.
What are the most common forms of brain injuries?
The most common type of brain injury is a concussion. This is normally the result of a direct blow to head but can also be caused by the force from whiplash.
Although it is a common injury it can cause pain and difficulties for many years. Some people will recover within days whereas others will still be feeling the effects for many years afterwards. With a concussion the blood vessels may stretch and can present with or without a skull fracture, swelling and brain bleeding.
Main points –
- The patient may or may not lose consciousness.
- The patient may appear dazed and confused in the immediate aftermath of the injury.
- May also be caused by violent shaking.
A contusion is a bruise on the brain and is normally the result of a direct impact to the head. It may also cause bleeding and swelling of the brain which may need surgery.
Main Points –
- 20-30% of all severe brain injuries involve a contusion.
- There is always a loss of consciousness.
- A person may recover quickly or could be left with permanent disabilities such as problems with their cognitive behaviour, a loss of memory, and problems with processing input from the five senses.
A coup-contrecoup is when a person suffers with a contusion on the brain at the site of the impact but also another one on the other side. When the force is strong enough to not only cause a contusion but it then causes the brain to move violently and hit the opposite side of the skull. The word contrecoup is French meaning, counter blow.
Main points –
- A coup-contrecoup may result in swelling and bleeding on the brain.
- Immediate medical attention is vital.
- Long term complications may include, difficulty with language comprehension, speaking, decision making, memory, balance, coordination and patients may suffer from muscle weakness and paralysis.
Diffuse Axonal –
A diffuse axonal is caused by shaking or a strong rotation of the head, for example a severe road traffic accident. This causes the brain structures to tear. There is normally extensive tearing of the nerve tissue and can cause brain chemicals to be released creating a further injury. The brain’s normal communication and chemical process is then disrupted.
Main points –
- A diffuse axonal can result in brain damage, a coma or can be fatal.
- It is one of the most common types of severe brain injuries but is the most devastating.
- The patient will most likely lose consciousness.
- There is no surgery available for this type of injury. The main form of treatment is to reduce any swelling that is present.
A penetration brain injury is the result of impact caused by a bullet, knife or sharp object that forces skin, hair and bone into the brain.
Main points –
- A penetration brain injury needs emergency medical treatment.
- Swelling is normally present due to the injury.
- Surgery can be used to remove any fragments that have entered the brain.
- A “through and through” injury is when the object enters the skull, goes through the brain and exits the skull on the other side.
A patient’s long term prognosis will greatly depend on the severity of the injury.
Mild Traumatic Injury –
- Loss of consciousness is very brief or does not occur.
- Scans appear normal
- Any changes to their mental state is only present at the time of the injury. They may appear dazed or confused but this is not long lasting.
Moderate Injury –
- Loss of consciousness lasts for a few minutes to a few hours.
- Concussion symptoms last from days to weeks.
- Physical and behaviour changes last for months or longer.
Severe Injury –
- Loss of consciousness for days, weeks or months.
- Long term changes in physical ability and can also cause cognitive and behavioural impairments.
- Changes in long or short term memory.
The most important point with any type of brain injury is to ensure that the patient receives immediate medical treatment. There is a wide range of testing from MRI scans to EEG’s to help the diagnostic process. The earlier the person receives treatment the better chance there is for a good long term outcome. Even if you think the patient seems to be okay, the brain is a complex organ that needs specialist care in the aftermath of any injury.