Traumatic Injury Anatomy

Traumatic brain injury, or TBI, occurs when there is a sudden, direct injury to the head. This type of wound can result from a bump, blow, or jolt to the cranium. It may even result from the penetration of a foreign object into the brain tissue. Most TBI’s result from car accidents, sports injuries, blunt trauma, unintentional injuries and falls, with falls accounting for about 40% of all TBI injuries. Much like stroke patients, individuals suffering from traumatic brain injuries may have to live with a variety of detriments based on the location and extent of their injury. For example, patients can experience impaired sensation, vision, hearing, memory, processing skills or even emotional and behavioral functioning ("Injury Prevention & Control: Traumatic Brain Injury.”) The purpose of this paper is to provide information regarding the pathophysiology, treatment and medical management of traumatic brain injuries, as well as to educate health care providers of the additional ways in which support can be provided to both patients suffering from these types of injuries and their families. A case study will be supplied to facilitate discussion of the topic.

In the United States alone, there are approximately one million head injuries reported every year; eighty five percent of these injuries are classified as mild traumatic brain injuries. Traumatic brain injuries, also known as concussions, are the leading cause of death and disability for neurological disorders before the age of fifty. Mild traumatic brain injuries (mTBI) are one of the most prevalent, and have become a major public health issue. A few of the main reasons there are so many problems with traumatic brain injuries (TBI), are lack of reporting by the patients, physician’s misdiagnosis or undiagnosed, and lack of awareness.

The individuals impacted the most by a traumatic brain injury are newborns to 4 years old, young adults 15-24 and elderly age 75 and older. (Solomons, Saltsman & Jamieson) ( January 3,2017 Placitella, C ) A traumatic brain injury can be classified into three different groups mild, moderate and severe. A mild patient may lose consciousness, typically for a few seconds or a few minutes. A moderate patient can lose consciousness for 1-24 hours. A severe patient can lose consciousness or be in a coma for more than 24 hours. It can also be put into subcategories coma, vegetative state, persistent vegetative state, and minimally responsive

Traumatic brain injury (TBI) is alterations of the brain function and brain pathology caused by an external force (LeBorgne, 2013). The two types of TBI are open and closed injuries (LeBorgne, 2013). Open injuries results from a penetration of the skull (LeBorgne, 2013). Closed injuries or no penetrating causes damage at the point of impact (LeBorgne, 2013). Closed head injuries include, but are not limited to concussion, contusion, and second impact syndrome (LeBorgne, 2013). A closed head injury involves edema, and an increase in intracranial pressure that causes further injury (LeBorgne, 2013). Between 2002 and 2006 falls were the leading cause of TBI among all age groups in the United States, followed by motor vehicular accidents, strike against an object and assaults (Powell, 2014). Falls related to the greatest amount of emergency department visits and hospitalization, compared to motor vehicular accidents that were the leading cause of death (Powell, 2014).

According to the Mayo Clinic, traumatic brain injuries generally occur when people suffer violent jolts or blows to their heads or bodies. This may be due to any number of factors, including assaults, contact during sports activities, falls or auto accidents. People may also suffer traumatic brain injuries when objects, such as bullets, pierce through the skull and enter the

Nonetheless, prior to an intricate look at the impact on specific brain structures, it is important to understand a TBI, the levels of severity and the immediate implications on a neurological level. The most typical TBI is that of a closed head injury in which no penetration of the skull or brain occurs (Roberts, 2009). Still, impact to the head results in the skull usually hitting a surface as a result of incidents such as falls, accident, sports, assault or abuse (Roberts, 2009). Once a TBI has occurred, a classification of the injuries severity is assessed based on the immediate presentation of symptoms (Roberts, 2009). Mild, moderate and severe classifications are determined based on the presentation (or lack their of) of symptoms such as consciousness and functioning of mental and or sensory process (Roberts, 2009). At the level of the neuron, TBI can cause critical problems. In cases where brain tissue stretches or is sheared, the axon of a neuron becomes weakened due to the stretching, which can result in the

“My name is Niamh... as I returned home and tried to face back into normal life it was clear that very little was normal anymore. I was no longer the Niamh I used to be”. (1) This was the last words from TBI (Traumatic brain injury) patient. Researchers over a decade discover that more than 130 million people visit the emergency room, because of traumatic injuries or a result of traumatic injury. (2) We can define traumatic injuries an injury that inflicted by physical activity, and the patients most of the time face threatening life injury. (3) Traumatic injuries can occur in many places such as a car accident or falling. (2) Most of the cases which visit the ER (Emergence Room) commonly classified into three main categories. First, according

The term “traumatic brain injury” (TBI) refers to a brain injury caused by trauma rather than disease, vascular accidents, or alcohol. Incidences of Traumatic Brain Injury have had a significant surge as they are more recognized by the medical profession. Occurring in many different ways; falls, sports, clumsiness, car accidents, tumors, surgery, mentality, etc, TBI is “...the most common form of brain injury in the modern Western world predominantly affecting young adults, many of whom suffer

The signs and sypmtoms of a minor head injury include; headache, lightheadedness, a spinning sensation, confusion, nausea, and temporary ringing in the ears. The signs and symptoms of a severe head injury include;

Injuries associated with TBI are divided into two categories: primary injuries and secondary injuries. Primary injuries are the direct physical damage incurred at the moment the trauma occurs. Secondary brain injuries occur indirectly as a result of trauma and usually appear hours or days after the initial injury. Secondary injuries exist as result of or separate from the initial injury. They cause complications such as hemorrhaging, alterations in intracranial pressure (ICP), and neurological deficits. Deterioration can occur even after patients have been downgraded from critical status. Approximately 40% of all cases of TBI deteriorate after hospitalization. These complications are a major cause of death in people with a TBI (Narayan et al., 2002). The brain normally maintains a state of homeostasis, meaning the cerebral perfusion pressure (CPP) stays within a normal range to adequately carry blood to the brain. The protective

Traumatic brain injury, or acquired brain injury, describes a sudden physical trauma to the brain. In many cases, traumatic brain injuries are caused by an industrial, or auto accident, which occur due to an employer’s or driver’s negligence. There are two main types of traumatic brain injury resulting from head damage: closed head brain injury and open head injury. Close head injury occurs when the brain sustains a blow caused by a sudden change in movement or momentum. In a closed head injury, the blood vessels that sustain the brain may be stretched or damaged. Open head injury occurs when an object penetrates the skull. The damage may cause bleeding in the brain and skull fractures.

Traumatic brain injury is defined as a “traumatic insult to the brain capable of producing physical, intellectual, emotional, social and vocational change” and can be divided into two categories: primary injuries and, if these subsequently increase ICP, secondary injuries which may manifest hours to days after the initial insult (Sanders, 2012).

Traumatic brain injuries are usually sustained when an individual sustains a brain injury due to an external force or accident. The key characteristics of traumatic brain injuries are varied, can range from mild to severe, and depend on many factors. The most common key characteristics of traumatic brain injuries are “physical impairment, sensory impairment, emotional disturbance, disruption of cognition, and language problems” (Raymond, 2000). The result of the traumatic brain injury can be temporary or permanent. Students however may very well retain some of their previous abilities and will need help to make the transition back to school with whatever adjustments may

Traumatic brain injuries (TBI) consist of pathological intracranial characteristics of altered brain function cause by an outside force. TBI’s have plagued emergency rooms in recent years. TBI’s are the number one cause for death and disability in American youth and young adults. The drastic increase in TBI prognosis has been credited for reasons such as; increased competitiveness in sports, increased speeds of automobiles and/or speed limits, increased incidence of thrill seekers, as well as advancement of imaging modalities. The development of certain imaging protocols has made diagnosis of TBI’s more common. Computed tomography (CT) and magnetic resonance imaging (MRI) have paved the way in the imaging and identifying process of TBI’s. With the variety of different levels of severity of TBI’s, the diagnostic imaging and the associated application of the Glasgow Coma Scale (GCS) is crucial. The GCS is a point scale in which a health care professional can rate the severity of a brain injury and use a numeric value to objectively track the progress or decline in the patient’s health. In some cases, the TBI may inflict secondary vascular trauma in which the GCS may assist in detecting.

A secondary factor contributing to the patient’s death by blunt force trauma is the dislocation of the atlanto-axial and atlanto-occipital joints. “Traumatic atlanto-occipital dislocation (AOD) results from a severe ligamentous injury, which usually has either a fatal or a potentially devastating outcome. Patients frequently succumb to a cervicomedullary injury from AOD at the site of the accident”. “Because of the relatively wide cross-sectional area of the spinal canal at the craniocervical junction, spinal cord injury is less common than expected. However, when present, neurological injury from AOD can be devastating, often leading to sudden death secondary to brainstem injury. Neural injury may be direct, as a result of traction or compression mechanisms, or indirect, secondary to cerebrovascular injury leading to