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Traumatic Brain Injury Symptoms and Diagnosis

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Jeff Sevey

Traumatic brain injuries often occur due to an acute event. One minute you are normal, the next, you’re anything but. In the United States in 2010, there were approximately 2.5 million emergency room visits, hospitalizations, or deaths involving traumatic brain injury (alone or with other injuries). Between the years of 2001 to 2010, the rate of traumatic brain injury emergency room visits increased by 70%. From the year 2001 to 2009, the rate of emergency room visits due to sports- or recreation-related TBI or concussion increased 57% among those aged 19 or younger.

The leading causes of traumatic brain injuries are falls. From the year 2006 to 2010, falls represented 40% of all TBIs in the United States. Unintentional blunt trauma is the second leading cause of TBIs and accounted for 15%.

Car crashes were the third leading cause of traumatic brain injuries, accounting for 14% of emergency room visits, hospitalizations, and deaths. If we look just at deaths caused by traumatic brain injuries, car accidents make up the second leading cause at 26% of deaths.

Your brain makes up who you are. A brain injury has the potential to affect every single area of your life. While a broken leg or similar injury affects only that area of the body, a brain injury affects your physical function as well as your personality and mental health and ability as well. The brain heals differently than other areas of the body. Where one person with a brain injury may heal quickly, another with the same injury may take an extended period of time to heal. No two brain injuries are ever exactly alike.

Very often, a traumatic brain injury will not be readily apparent immediately after an accident. The person who sustained the injury may not even realize they’ve been hurt, and that is one of the most frightening aspects of a TBI. Symptoms of a traumatic brain injury may show up weeks, months, or in the case of children with developing brains, even years after the accident occurs.

Mild Traumatic Brain Injury Symptoms

If, after an accident, you are unconscious, confused, or disoriented for less than 30 minutes, that would be classified as a mild TBI. Mild TBI may also be called a concussion, minor head trauma, or minor brain injury. Usually in these cases, the MRI or CAT scans appear normal, even though the victim may experience headaches, difficulty forming thoughts, loss of memory, mood alteration, and irritability. Many mild TBI injuries are simply overlooked, or blamed on the stress of the accident, but not on any particular injury that occurred.

The mild TBI is the most prevalent, and 15% of all people exhibiting symptoms will experience those symptoms for a year or longer. Symptoms occurring after the injury are known as post concussive syndrome and include (but are not limited to) fatigue, headaches, visual disturbances, sleep disturbances, balance disturbances, irritability, distractibility, depression, seizures, nausea, sensitivity to sound or light, confusion, and inability to think quickly.

Any or all of these symptoms may not appear or be noticed at the time of the injury but may show up days or weeks later. They are often subtle enough so that the victim doesn’t even mention them to the doctor or their own family. The victim may appear to be acting and moving normally, but they are unable to think clearly. Frustration by this inability to form thoughts is what may bring them into a doctor to be examined and treated.

Severe Traumatic Brain Injury Symptoms

A TBI can be anywhere from mild to severe. They result in permanent damage that can cause life-long problems. Moderate brain injuries will typically result in a loss of consciousness from 20 minutes to six hours. Loss of consciousness that lasts over six hours is classified as a severe brain injury.

The full impact of a moderate to severe traumatic brain injury depends on many factors, such as:

  • The severity of the original injury
  • How completely the victim has recovered physiologically
  • The bodily functions that have been affected by the TBI
  • The bodily functions not affected by the TBI

The result of a moderate to severe traumatic brain injury can be any of the following, which is not an exhaustive list:

  • Cognitive deficits including attention span and concentration, distractibility, inability to remember, processing speed, confusion, language processing, and impulsiveness.
  • Speech deficits including the inability to understand spoken words, slurred speech, difficulty enunciating words, speaking extremely fast or slow, and problems with reading and writing.
  • Sensory deficits including inability to interpret touch, temperature, movement, and proprioception (the awareness of your body in space).
  • Perceptual deficits including integrating sensory data into meaningful information.
  • Visual deficits including blurred vision, loss of vision (total or partial), weakening of the eye muscles, double vision, loss of depth perception, involuntary eye movements and a lessened tolerance for brightness and light.
  • Auditory deficits including loss of, or decrease in hearing, tinnitus, lessened tolerance for loud noises.
  • Seizures that result in a disruption of consciousness, loss or lessening of sensory perception, and loss or lessening of motor movements.
  • Physical changes such as chronic pain, loss of control of bowel and bladder, sleep problems, physical paralysis, changes in appetite, changes in menstrual cycle, loss of stamina, and lessened ability to properly regulate body temperature.

Diagnosis of Traumatic Brain Injury

The more severe the TBI, the more evident it is to the victim and those surrounding the victim. But the focus immediately after an accident is on life-saving, so a closed-head injury may often be missed. If the patient is sedated and/or on a ventilator, the injuries will not become apparent until the victim is allowed to “wake up”. It is then that a medical evaluation can take place. A mild TBI may not be diagnosed until the victim realizes that they can not do things they were able to do previously.

Trauma to different areas of the brain will cause distinctly different symptoms. An injury to the front lobes will cause loss of the higher cognitive functions, such as inhibition. This can lead to inappropriate behavior that the victim is unaware is inappropriate. An injury to the cerebellum results in a loss of coordination and balance. An injury to the brain stem could result in loss of sexual arousal, or affect functions such as breathing and heart rate.

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