Minnesota Car Accidents: Traumatic Brain Injury Primer
Brain injuries are the fourth leading cause of death in the US, and the leading cause of death in people under 40 years of age. Just as the rest of the body is susceptible to bruising and breaking, the brain too can endure serious trauma. According to the Brain Injury Association of Minnesota, 100,000 Minnesotans live with a traumatic brain injury.
It is estimated that nearly 500,000 head injuries are sustained each year in the United States, at a rate of about 200 per 100,000. These statistics involve injury victims who have been admitted to a hospital. A recent study has suggested that all head injuries (both unreported and reported) total nearly 8 million annually across the country.
There are three broad categories of traumatic brain injuries:
- Blunt trauma involves a blow to the head from a heavy object. Whether or not the skull is penetrated, some amount of the kinetic energy from the strike is transmitted to the brain and other cranial contents through of pressure waves. These signals cause a neurological balance within the brain.
- Penetrating trauma from a bullet or other projectile produces by far the most destructive concussive-compressive injury. Damage results from both the object itself, and the impact forces crushing the brain tissue.
- Acceleration-deceleration forces may also cause injury. The most common example of an acceleration-deceleration injury is seen in the victims of motor vehicle accidents. Damage occurs as a result of the inertial forces, and tends to be more severe and widespread.
When a car traveling at high speed comes to a sudden stop, the body and head continue moving forward at the original velocity until brought to a stop after impacting the surface in the vehicle. In just seconds, the brain is subjected to powerful acceleration and deceleration forces, transferring large amounts of kinetic energy to the internal brain membranes.
There are three levels of trauma that may be distinguished: (1) concussion, (2) contusion, and (3) laceration.
A concussion, very common, is a jarring shock that damages the brain. A typical hockey or football player can tell you about these. On the other hand, a contusion involves actual bruising of the brain tissue. These are obviously more serious than a concussion. Finally, a laceration involves direct penetration or cutting of the brain tissue.
Brain injuries may also be classified as "primary" or "secondary."
Primary injuries result directly from trauma, while secondary injuries appear later as complications from a different primary injury. Secondary effects are not easily recognized at the onset of a brain injury. In time, however, the debilitating nature of head trauma presents itself more fully.
Management of head injuries has improved significantly over the last few decades, both in diagnosis and treatment. Early and aggressive management of head injuries will improve the outcome substantially. It is vitally important that you seek medical care if you believe you have sustained even a mild traumatic brain injury. Help is available to you.
The treatment rendered will depend upon the grade diagnosis, which can be either a level I, II, III. or IV.
Grade I is considered a mild injury, and constitutes the vast majority of trauma patients seen in a hospital. Although awake and alert, these patients often suffer short-term loss of consciousness or amnesia. Most recover without difficulty; secondary effects are minimal.
Grade II head injury is moderate, with patient alertness but sluggishness. They are treated carefully as the patient may easily fall into a Grade III if left alone. Care is similar to those with more severe head trauma, including hospitalization, steroid use, and the use of antiepileptic drugs.
Grade III injuries are severe, and the patient's consciousness is impaired to the point where she cannot follow simple commands. Doctors employ an aggressive approach to care, including a host of diagnostic studies, surgical intervention, psychological evaluations and therapeutic agents.
A Grade IV brain injury presents no evidence of brain function. Of course, they are the most serious type of brain injury. While the perception of society is that the classic "Grade IV" injury is what a brain injury actually is, these injuries are relatively uncommon.
Aside from traditional physical treatment, physicians will employ a series of psychological tests in an attempt to diagnose the "non-physical" injury of the brain. These may include a host of objective personality tests, the Minnesota Multiphasic Personality Inventory (MMPI), projective personality tests, and intelligence tests such using the Wechsler Adult Intelligence Scale or the Stanford-Binet test.
Cognitive defects present the most unique challenge to brain injury victims. To the outside world, the injured person looks and acts completely normal. Inside, however, a "different person" exists. Treatment is improving and involves retraining for various skills, such as problem-solving and abstract thinking.
A brain injury patient's prognosis is based on a host of factors, including: age, length of coma, posttraumatic amnesia, location and extent of brain lesion, responsiveness, TANS signs, Glascow Coma Scale score, and other indicia of injury severity. Naturally, your physician is in a much better position to offer predictions about your future.
