Brain injury

For the scientific journal on brain injuries, see Brain Injury (journal).
Not to be confused with Nerve injury.
A CT of the head years after a traumatic brain injury showing an empty space where the damage occurred marked by the arrow.

A brain injury is any injury occurring in the brain of a living organism. Brain injuries can be classified along several dimensions. Primary and secondary brain injury are ways to classify the injury processes that occur in brain injury, while focal and diffuse brain injury are ways to classify the extent or location of injury in the brain.

Types of brain injury

Traumatic brain injury

A traumatic brain injury ("TBI") is an alteration in brain on a structural, physiologic, chemical and/or neurotransmitter pathway as well as other evidence of brain pathology, caused by an external force. (“About Brain Injury”). A post-traumatic brain injury is the alteration of the neurologic function by the TBI event. Multiple TBI events can lead to chronic traumatic encephalopathy.

Concussion

A concussion is the most common type of traumatic brain injury. It can be caused by direct damage to the head, gunshot wounds, violent shaking of the head (very common in children), or force from a whiplash type injury. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. The blood vessels in the brain may stretch, and cranial nerves may be damaged.

Contusion

A contusion could be caused by direct damage to the head, where a bruise is bleeding on the brain.

Coup-contrecoup injury

A coup-contrecoup injury occurs when the force impacting the head is not only strong enough to cause a contusion at the site of impact, but also able to move the brain and cause it to slam into the opposite side of the skull, which causes the additional contusion.

Diffuse axonal injury

A diffuse axonal injury can be caused by strong shake on the head, as in "shaken baby syndrome", or by rotational forces, such as a car accident. Injury occurs when the unmoving brain lags behind the movement of the skull and causes the brain structures to tear. The tearing of the nerve tissue disrupts the brain communication and chemical processes. This disturbance in the brain would cause brain damage or death. There are specific areas that will shear connections within the brain substance that are indicative of a diffuse axonal injury.

Locked in syndrome

Locked in syndrome is a rare neurological condition wherein the patient is unable to physically move any part of the body except the eyes. The patient is still conscious and able to think.

Penetrating injury

A penetrating injury occurs when a sharp object enters the brain. This causes a wide area of damage. The penetrating injuries caused by bullets have a 91% mortality rate overall.

Acquired brain injury

An acquired brain injury is an injury to the brain that has occurred after birth. It is not hereditary, congenital, degenerative, or induced by birth trauma.

Anoxic brain injury

Anoxic brain injury occurs when the human brain doesn’t receive any oxygen. Cells in the brain need oxygen to survive and function.

Hypoxic brain injury

Hypoxic brain injury happens when the brain receives insufficient oxygen. A hypoxic brain injury, also called stagnant hypoxia, is caused by the critical reduction in blood flow or low blood pressure which leads to the lack of blood flow to the brain.

Treatments and drugs

Traumatic brain injury

Mild traumatic brain injuries needs no treatment other than rest. The treatment for Emergency traumatic brain injuries focuses on making sure the patient has enough oxygen, blood supply and trying to keep the blood pressure, and avoid further injury from the head or neck. The emergency traumatic brain injuries might need to take surgeries which are removing clotted blood, repairing skull fractures or cut a hole in the skull. The drugs that are used for the Traumatic Brain Injury are Diuretics, Anti-seizure drugs and Coma-inducing drugs. Diuretics would reduce the fluid in tissues which helps reduce the pressure inside the brain. In the first week of the traumatic brain injury, patients have a risk of having seizures. Anti-seizure drugs would prevent patients from the seizures. Coma-inducing drugs would temporary comas the patients and requires less oxygen to function which is very helpful during the surgery. (“Traumatic Brain Injury”)

Common problems after brain injury

The memory of the patients might decrease due to the brain damage (Johnson 18). There will be headaches about brain injury which about 50% of the patients do. The head injury patients would feel pain in their back of the head, neck or shoulder and might get worse over time (Johnson 26). The head injury would also cause you brain overload and the brain is not able to handle the information (Johnson 36). The brain injury patient would also feel stressed, easily tired and find difficulty sleeping (Johnson 38). The mood of the patient could become very extreme (Johnson 44).

Are children and adults affected differently?

The human brain would keep developing until age 20 to 25. If the brain is damaged during this time, then the patient physically might fully recover, however, they will not be able to pick up some new skills. The children's brain is easier to get damaged (“What Is Acquired Brain Injury?”). The time to recover the injury for children also takes 6 to 10 times more than the adults. Jeffrey Barth, PhD in the University of Virginia School of Medicine did an experiment which gives child or adult mice a mild brain injury and record how many days it would take to recover. Jeffrey Barth, PhD stated that “the children is more vulnerable to injury and will take 6 to 10 times more time to recover than the adult” (Barth).

References

"About Brain Injury." Brain Injury Association of America. National Brain Injury information center, 12 Oct. 2012. Web. 02 Mar 2016.

“Traumatic Brain Injury.” MAYO CLINIC. 15 May 2014. Web. 4 March 2016.

Johnson, Glen. "TRAUMATIC BRAIN INJURY SURVIVAL GUIDE."TRAUMATIC BRAIN INJURY SURVIVAL GUIDE (2010): 1-86.TRAUMATIC BRAIN INJURY SURVIVAL GUIDE. Glen Johnson, 2010. Web. 4 Mar. 2016.

"What Is Acquired Brain Injury?" Brain Injury Hub. The Children's Trust, 4 Jan. 2016. Web. 05 Mar. 2016.

Barth, Jeffrey. "Child Brain Versus Adult Brain with TBI." BrainLine Kids. BrainLine, 28 Apr. 2011. Web. 05 Mar. 2016.

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