Head Trauma and Traumatic Brain Injury: What You Need to Know

Many Severe Head Traumas are Preventable

rendering of car accident resulting in head injury
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Over 2 million Americans are affected by head trauma every year. When the head receives a traumatic blow, damage to the brain, such as swelling, bruising and tearing of important cerebral pathways can occur. This is called a traumatic brain injury (TBI).

Many head traumas, traumatic brain injuries and deaths are avoidable through basic preventative measures. For example:

  • Removing fall and trip hazards at home
  • Wearing a seat-belt when in a moving vehicle
  • Always wearing a helmet on a bike or motorcycle
  • Using work safety equipment as directed

There is a solid body of research that proves moderate and severe traumatic brain injury can lead to life-long disability. Emerging research demonstrates that mild and repetitive brain injuries also lead to long term cognitive and psychological changes, which decrease overall quality of life.

Who Is Injured and Why?

According to the Centers for Disease Control (CDC) men are three times as likely as women to suffer from head trauma. Motor vehicle accidents are the most common cause of traumatic brain injury between the ages of 4 and 24. Tripping and falling is the primary head trauma cause in individuals over 65 years of age.

Two Types of Head Trauma

Head trauma is classified as either closed or open.

Closed head trauma occurs when the body and head rapidly accelerate and decelerate.

For example, this happens in a car accident when the car impacts another object. The body is thrown toward the dashboard, and next thrown back into the seat.

This movement causes the brain to first strike the front of the skull, and second strike the back of the skull. The centrifugal forces from the accident continue to shake, twist and strike the brain against the inside of the skull for several minutes.

Open head injuries occur when an object such as a bullet, knife or accident debris punctures through the skull and into the brain.

Focal versus Diffuse Injuries

Brain injury is classified as focal or diffuse.

Focal injuries are limited to one specific area and happen when there is a penetrating injury during a head trauma. A focal injury happens during head trauma when there is a penetrating injury. For example, if a nail gun accidentally goes off and shoots a nail through the skull and into the brain, there is a focal injury.

The prognosis for focal injuries depends on what part of the brain was damaged, and the amount of time between the injury and treatment. The good news about focal head trauma is that the outcomes are usually better than with diffuse injury.

Diffuse traumatic brain damage occurs when the entire brain receives a shock. For example, this type of injury happens to soldiers during war when they are in close proximity to a bomb blast. Blast injuries cause intense pressure shifts within the brain.

This leads to abnormal movement and tearing of brain tissues, resulting in nerve cell damage.

Diffuse injuries are microscopic in nature. This microscopic nerve damage directly interferes with the ability of brain signals to travel from one side of the brain to the other. Right after a diffuse brain injury there are also many chemicals and enzymes released from the brain's nerve cells, that cause more damage.

Long Term Effects

The long term effects of head trauma and brain injury depend on the severity of the initial damage, how long it takes to reach emergency services, and access to rehabilitation during the recovery phase. Adequate resources and social support are also needed to successfully integrate back into the community.

In moderate to severe brain injury memory problems, difficulty concentrating and personality changes may never resolve. In milder injuries fatigue and changes to sense perception, such as the eyes’ ability to focus, can last for years. Head trauma and TBI cause a complex symptoms and recovery varies widely.

Sources

Centers for Disease Control (2014); Injury and Prevention Control: Traumatic Brain Injury; Retrieved from http://www.cdc.gov/TraumaticBrainInjury/data/index. html

McDonald, B. C., Saykin, A. J., & McAllister, T. W. (2012). Functional MRI of mild traumatic brain injury (mTBI): progress and perspectives from the first decade of studies. Brain Imaging And Behavior, 6(2), 193-207. doi:10.1007/s11682-012-9173-4

Ojo, J. O., Mouzon, B. C., & Crawford, F. (2015). Repetitive head trauma, chronic traumatic encephalopathy and tau: Challenges in translating from mice to men. Experimental Neurology, doi:10.1016/j.expneurol.2015.06.003

Thiagarajan, P., & Ciuffreda, K. J. (2014). Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury. Journal Of Rehabilitation Research & Development, 51(2), 175-191. doi:10.1682/JRRD.2013.01.0027

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