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Traumatic brain Injury or TBI
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A Traumatic brain injury (TBI) results from a physical assault to the head, causing structural and functional abnormalities of the brain.
- Types of head trauma
- Skull fracture
- Concussion -- temporary loss of consciousness without a structural change of brain
- Diffuse axonal injury -- a condition in which the axon is stretched and cut by a sudden acceleration, deceleration or rotation force to the head.
- Contusion --
bruising of the brain tissue
- Hematoma or bleeding
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The
symptoms vary according to the severity and extent of damage
to the brain.
- Nausea, vomiting, headaches, or changes in mental status
- If the damage is serious, there may be a loss of consciousness
- Seizures
- Paralysis of the limbs due to a muscle weakness
- Loss of sensation and numbness
- Intellectual dysfunction
- Speech problem -- dysarthria, aphasia
- Visual problems
- Personality changes
- Loss of bowel and bladder control
- Emotional or behavioral problems
- Swallowing difficulty
- Memory loss
- In children, the symptoms can occur over 24 hours after a head injury due to delayed hemorrhages, so close observation is important for at least 1 or 2 days after the time you suspect a concussion may have occurred.
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The most common cause is car accidents.
- Other causes include falls, direct blows to the head, and penetrating injuries.
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History of the injury, symptoms and a neurological examination are the first steps in assessing patients with possible brain injuries. Brain CT or MRI scans are necessary to confirm the location and extent of brain damage.
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- Treatment depends on the severity, type of injury and complications.
- Skull fractures or diffuse axonal injuries do not require surgery.
- Treatment is focused on the prevention and management of complications as well as getting control of the swelling in the brain
- Surgical removal is necessary for large hematoma or contusions that compress the brain tissue.
- Small bleedings or deep-seated hematoma is generally treated by conservative management.
- Physical therapy and occupational therapy help to maximize the muscle power, which improves the functional ability, preventing complications such as contracture.
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The prognosis of head injuries varies according to the severity and extent of the injury, the patient's age and secondary complications such as hydrocephalus. Mild injuries do not cause any after effects. In severe damage, there can be permanent problems such as motor and/or sensory weakness, speech problems, intellectual dysfunction and visual problems.
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