Traumatic Brain Injuries and Post-Concussion Syndrome

TBI can occur after falls, car accidents, or other head injuries and emerge as a chronic issue

Mar 18, 2016 | Categories: News | Tags: Accidents

A TBI, traumatic brain injury, can happen to anyone, whether it happens while playing sports, at work, or while taking a drive or leisurely walk on a sunny afternoon. Most people who suffer from a TBI will recover within a fairly short time period, but there is a significant minority that may develop chronic problems.

A TBI is caused by a bump, blow, or jolt to the head that disrupts the normal function of the brain. In other words, the brain damage results from (1) a sudden impact to the head by a contact force from the impacting object based on its size, mass, and density of the object or (2) significant acceleration or deceleration of the head by an inertial force, from the motion of the head and the brain within the skull. For instance, car accidents can involve contact forces due to substantial impacts with the steering wheel or airbag that result in brain damage at the point of impact, but most brain damage results from inertial forces due to significant acceleration and deceleration of the head.

TBIs are classified as mild, moderate, or severe depending on the location and extent of the injury. The type of brain injury that occurs depends on the types of forces that are acting on the head. A focal brain injury, which is an injury confined to one area of the brain as a result of the direct blow to the head, is produced by a contact force. A diffuse brain injury, which is an injury that occurs over a widespread area of the brain or throughout the brain as a result from brain tissue undergoing varying densities of acceleration at different rates, is produced by an inertial force. Many brain injuries are a combination of both focal and diffuse injuries, but each type of brain injury can occur alone. Diffuse brain injuries are much more difficult to document than focal brain injuries.

To picture this, imagine the brain as a ball with the the consistency of Jell-O. The Jell-O brain is floating in fluid, called the cerebrospinal fluid. The Jell-O brain and the fluid are encased by a very hard skull with a slightly rough inner surface of the skull. If you fall, hit your head, or move it too quickly, the brain gets jerked back and forth. The soft brain may strike itself on the inner portion of the skull with damage occurring from contact with the rough inner surface. The soft brain may get jerked forward and backwards, squishing the brain on itself and then stretching it as the head goes back and forth, with damage occurring to the nerve cells throughout the brain as they are stretched and torn, rendering them nonfunctional, either temporarily or potentially permanently.

According to research, up to 50% of patients discharged from the emergency department with minor head injury will develop post-concussion syndrome within 1 month of injury. Symptoms can range from mild and transient to disabling and constant. If you hit your head due to a fall or on an object or you were in a car accident, no matter how minor, please pay attention and document any symptoms of traumatic brain injury.

Cognitive symptoms include attention/concentration problems, memory loss, and confusion/disorientation, and impaired social judgment. Behavioral symptoms include irritability, depression, anxiety, sleep disturbances, problems with emotional control, and loss of initiative. Physical symptoms include headaches/migraines, dizziness, insomnia, fatigue, uneven gait, nausea, sensitivity to light and sound, blurred vision, and seizures. Rest is the mainstay of treatment for post-concussion syndrome, but if the symptoms are getting worse or they don't get better, it's time to see a brain injury specialist.