Traumatic Brain Injury Treatment

Traumatic brain injury is damage to bones and tissues of varying severity resulting from a blow. These injuries vary widely in the location, nature and severity of damage to brain structures. Brain tissue and membranes, blood vessels and nerves may be affected.

The primary brain injury occurs at the point of impact, but even more significant damage is often located in the contrecoup zone on the opposite side of the skull.

Classification of traumatic brain injury by the nature of the damage:

• closed: without breaking the integrity of the skull covering;
• open penetrating: with damage to the dura mater and the soft tissues of the head;
• open non-penetrating: does not involve the dura mater.

The clinical picture can vary depending on the severity of the damage.

Traumatic brain injury is classified as mild, moderate or severe (acute brain compression, severe contusion).

Injuries are also classified as:

• isolated: without damage to other parts of the body;
• combined (multiple): when TBI is accompanied by damage to other organs of the body;
• mixed: caused by several types of energy.

The main causes of TBI include household, work and sports injuries and road accidents.

Symptoms

The main symptoms of TBI in adults:

• prolonged headache;
• depressed consciousness or loss of consciousness;
• memory disorders, partial amnesia;
• facial flushing, bleeding, leakage of cerebrospinal fluid from the nose or ears;
• vomiting and nausea, rapid breathing, elevated blood pressure.

If any of these signs appear, call an ambulance immediately and lay the patient on their back if they are conscious, or on their side if they are not.

Diagnosis

The injured person should be taken to a medical facility in a horizontal position, where they should be examined by a neurologist or a trauma specialist. Diagnosis includes the following measures:

• medical history;
• neurological examination, including the fundus of the eye;
• skull X-ray in two projections;
• CT and MRI.

MRI has the highest sensitivity and information value.

Treatment Methods

TBI treatment in a medical center begins with diagnosis. An important stage is restoring normal breathing, including connection to a ventilator, which helps normalize gas exchange and is a way to prevent brain swelling.

The next stage in treating open traumatic brain injury is wound care and suturing. If necessary, surgery is performed to remove foreign objects and fragments.

For mild TBI, it is important to provide the patient with rest and bed rest. Medications are then prescribed to restore consciousness, relieve pain and stabilize the patient's condition. Measures are then taken to prevent brain swelling, and nootropic and anticonvulsant therapy is prescribed.

During treatment, three periods of TBI are distinguished:

1. Acute, when the injured tissues are in a state of interaction, lasting 1-8 weeks (up to 19 weeks in severe cases).
2. Intermediate, when the damage gradually resolves and adaptive and compensatory processes develop in the central nervous system, lasting from 2 months to half a year.
3. Late, during which regeneration processes are completed and, with an unfavorable course, adhesions and other pathological processes develop.

The duration of treatment for traumatic brain injuries depends on the severity of the damage and the effectiveness of the prescribed therapy.

With a favorable outcome, full stabilization of the patient's condition can take 2 years or more.

Rehabilitation

After a head injury, a person is out of active life for a long time and often loses the ability to work. Even a relatively mild injury can cause serious complications and provoke changes in the body. That is why rehabilitation plays an important role.

For rehabilitation after TBI, it is important to turn to a specialized clinic where specialists will create an individual program to help restore the body and minimize the negative effects of TBI.

The main methods used by rehabilitation specialists to help restore the body:

• physical therapy procedures;
• reflexology: influence on biologically active points on the body;
• massage to help restore walking after TBI, which stimulates blood circulation and activates muscles;
• therapeutic exercise after TBI is a set of exercises performed under the supervision of a specialist that help prevent degenerative changes in tissues.

In severe TBI, massage, exercise therapy and physical therapy procedures can be useful already at the first stages of rehabilitation.

Consequences

TBI is one of the most dangerous injuries because it carries a high risk to the life of the injured person. In addition, the consequences of brain injury can appear either immediately after the damage or some time later:

• impaired motor skills and movement;
• loss of speech function;
• decreased vision and cognitive abilities;
• chronic pain;
• depression.

If the injured person does not receive timely help, the risk of disability increases significantly.

Treatment in Kyiv

TBI is a common injury that carries a risk to life. Patients with any brain injury should be taken to a hospital, in some cases they need the help of a neurosurgeon, and afterwards full follow-up care.

The goal of TBI treatment is to normalize the functional state of the brain, reduce headache and normalize sleep.

The main medications are analgesics and sedatives.

When treating TBI in adults at a clinic in Kyiv, patients are helped by experienced specialists, such as neurologists and rehabilitation specialists; a neurosurgeon is involved when needed. Treatment is carried out in accordance with international standards and protocols. The clinic has modern diagnostic equipment, which helps establish an accurate diagnosis and choose appropriate treatment.

Sources

• Journal "Acute and Emergency Conditions in Physician Practice"
• Ukrainian Wikipedia