The Symptoms and the Treatment of Traumatic Brain Injuries - Research Paper Example

The world we live in has been a place of ‘incessant’ activities, with the people involving themselves in various activities using their physical and mental part. However, this activeness of humans could be ‘paused’ due to physical and mental afflictions. The physical component of the human body could be injured or diseased or could even malfunction due to some deficit. Thus, when the physical organs get affected, people could become temporarily ‘inactive’ or in worst cases even permanently, that is vegetative state and death. If the main organ of brain gets injured or diseased or malfunctions, the resultant pause in ‘activeness’ will have a extreme effect, with the individual struggling to live even a semblance of normal life. Both their personal as well as professional life will be jeopardy, with no clear alternatives, at least in the early period. Among the various problems that will affect the brain, Traumatic Brain Injuries (TBI) are the most common and at the same time severe mode through which brain gets affected. So, this paper will focus on Traumatic Brain Injuries (TBI) discussing how it is caused, the levels of injuries, the symptoms and finally the treatment. TBI- Background TBI is a traumatic injury to the brain or brain tissue caused by a sudden traumatic condition. Traumatic condition can be caused, when the head suddenly and violently gets hit or struck by a heavy object or piercing object, which injures the brain tissue. The events that could trigger the traumatic condition could include accidents involving automobiles, bicycles and even pedestrians, also due to violence, such as gunshots and child abuse, as well as due to sports injuries. (TBI Recoverycenter.com). Traumatic brain injury (TBI), a form of acquired brain injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. (ninds.nih.gov). TBI is considered as one of the major causes of death as well as disability all over the world, particularly among the young adults and children. It can lead to many negative effects on the physical, emotional and behavioral aspects of individual’s living, with the final outcome ranging from complete recovery, temporary or permanent disability and in sizable cases death. Each year, an estimated 1.5 million people in the U.S. sustain a traumatic brain injury. The impact on their families and caregivers is immense. (caregiver.org). Levels TBI is usually classified into different types or levels, based on the severity of the injury, or mechanism based classification, or finally levels based on the pathological features of the injury. Severity based classification includes mild, moderate, and severe categories and it is classified based on preset criterions in the Glasgow Coma Scale (GCS). Glasgow Coma Scale (GCS) use the injured patient’s visual, motor, and verbal responsiveness to measure level of consciousness. Scores of 8 or below are considered to represent a true coma (no eye opening, no response to simple commands, and unable to communicate) and to indicate a severe brain injury. Scores from 9 - 12 are suggestive of a moderate brain injury, while scores of 13 and above are thought to indicate that the brain injury is mild. (Katz et al.). Based on mechanism-related classification, TBI is divided into two levels, closed and penetrating head injury. The closed, non-penetrating and blunt injury level is given to injuries, in which the brain is not exposed. A penetrating, or open injury classification level is given to injuries in which any object has pierced the skull and has impacted the brain, breaching the dura mater. Apart from these two classifications, the widely accepted scientific based classification is the one based on pathological features of the injury. Injuries can be divided into extra-axial, which constitutes the injuries that occur within the skull but outside of the brain, and intra-axial, the injuries that occur on the brain tissue. They are further classified into focal or diffuse, with focal injuries limited to specific areas and diffuse injuries distributed in a more general manner. Injuries like edema (swelling), diffuse axonal injury and importantly concussion all come under diffuse injuries, as the injury covers a more general area and will be of mild severity. Focal injuries are of deeper severity, with the brain tissues and parts like orbitofrontal getting affected. Cerebral contusions (bruising of brain tissues) and cerebral laceration (when the tissue is torn or cut) comes under focal injuries. Symptoms The symptoms of TBI are dependent on whether the injury is diffuse or focal, and also based on the part or side of the brain that is affected. Side of the brain is also a factor because unconsciousness tends to be longer for people, who had injuries on their left brain, than those with injuries on the right. Thus, from overall perspective, it is clear that the symptoms may be mild or very severe all depending on the extent of the damage. A person may feel mild pain, loss of consciousness or confused for a while when experiencing mild brain injury. “Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking.” (ninds.nih.gov). When experiencing severe head injury, there will be same above mentioned symptoms, but in a severe form, with a persistent headache, followed by nausea or vomiting. Other symptoms include convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation. (ninds.nih.gov). There will be also long-term symptoms when the injuries are in the levels of diffuse or severity, which could include certain cognitive changes like Shortened attention span, Problem-solving difficulties, Partial or complete loss of reading and writing skills, Difficulty learning new things, etc (caregiver.org). Treatment T he first and foremost form of treatment for TBI is to begin the emergency treatment within one hour or “golden hour” following the injury. Treatment should be quick because, when the brain gets injured, the nearby parts and other organs could also start to damage or deteriorate. As the initial damage caused by the trauma is irreversible, with quick treatment damage to other parts can be prevented. “Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with TBI and focus on preventing further injury” (ninds.nih.gov). So, both during the transportation to the hospital and in the hospital, care should be taken to stabilize the patient, thereby preventing further damage. Care has to be taken to ensure proper oxygen supply to the brain as well as to the rest of the body, then any loss in blood should be compensated with adequate blood flow, and importantly blood pressure has to be kept on permissible limits. Even while carrying out all these above mentioned steps, imaging tests using MRI scan, CT scan, X-rays, etc will be done to determine the exact impact of the injury, severity of the injury, in total the nature of the injury. Following the diagnosis, more steps will be taken to stabilize the patient further, including inserting a catheter into a ventricle of the brain, to allow cerebrospinal fluid to drain and thereby to release blood pressure in the skull. High blood pressure can also be reduced by doing simple things like tilting the patient's bed, thereby straightening the head, which will lead to more blood flow down from head. In addition, pressure can be controlled through infusion of drugs like norepinephrine. When there is mass lesions like blood clots or pierced objects, surgery needs to be carried out to minimize the damage. When the patient regains consciousness and is somewhat physically fit, rehabilitation programs have to be carried out to make the patient independent as much as possible. “The goal of rehabilitation is to help your loved one live and function as independently as possible. Rehabilitation helps the body heals and assists the brain in relearning processes so that an individual… (will) learn new ways to do things if any previous abilities have been lost.” (caregiver.org) Works Cited caregiver.org. Traumatic Brain Injury. Family Caregiver Alliance, n. d. Web. 15 Nov 2010. Katz, Robert., Jennifer McCain., Syed Rahman and Noreen Bock. Frequently Asked Questions: HOW DO WE KNOW HOW BAD THE HEAD INJURY IS? Jamaica Hospital Medical Center, 19 Feb 2002. Web. 16 Nov 2010. ninds.nih.gov. NINDS Traumatic Brain Injury Information Page. National Institute of Neurological Disorders and Stroke, n. d. Web. 16 Nov 2010. TBI Recoverycenter.com. Traumatic Brain Injuries, n. p. Web. 16 Nov 2010. Read More