Can you name something that kills 50,000 people every year, without drugs or alcohol? We can. It’s traumatic brain injury and those are the people who don’t make it.
There are one million people a year treated for brain injuries, that live. Overall, more than 2% of the US population lives with or is living with the consequences of a brain injury.
Brains are complex, they’re essential for function but made of squishy soft matter. Learn about trauma and the brain, car accidents, and common complications in the piece below.
How Common Are They?
To revisit the statistics above, about 1 million people a year get brain injuries. Of that number, 50,000 people die from their trauma.
The biggest correlation factor, by far, is motor vehicle accidents. Accident related brain injuries make up 50% of all cases. Falls follow car wrecks in correlation for the old and the young.
Like insurance rates dictate, men between the ages of 15-24 are the most susceptible. Most of them drive fast or lack adult impulse control. Brains develop up to 25 years old.
Often brain injuries aren’t a one and done deal. It’s said that once you get your first brain injury, you’re 3x as likely to get a second.
If you get a second, you’re eight times more likely to get a third. In the world of statistics, those are huge numbers!
What Do They Look Like?
The number one symptom of brain trauma is a change in consciousness. Some people find they’re confused, others feel sleepy, while others still experience a headache.
Vomiting and nausea are common signs of a head injury, though can also be from shock.
One of the biggest issues in properly diagnosing brain injuries is that trauma symptoms are subtle. Many people walk away from a car crash thinking they’re fine when they shouldn’t have moved at all.
If you are in a bad car accident, try not to move your body unless you’re going to get more hurt staying where you are.
The same is true if you witness another person’s brain injury, do not move them or manipulate their position. In some cases, there’s as little as one nerve keeping them from having a stroke.
First responders are trained to move people with potential brain injuries. The way they transfer people minimizes risk and they can do a quick assessment of the scene.
Diagnosing Brain Injuries
Here are some symptoms first responders or doctors will look for to diagnose a brain injury:
- Check consciousness
- Cranial nerve functionality: eye functionality, face symmetry
- Motor functions: strength and regularity of movements
- Breathing patterns: is it too shallow? Abnormal otherwise?
- Check reflexes: like a knee-jerk
- Sensory functions: feel pain, pinprick test
- Trauma physical signs: bruises, bleeding, scratches
If you’re taking your friend in for a suspected brain injury or are going in yourself, it’s helpful to stay with them. If the doctor allows it, it’s helpful for you to tell them any changes you see in their behavior.
Do they seem spacey? A little off and you can’t put your finger on it? Likely this is the first time you’ve seen this doctor, so they don’t know what’s normal.
Tell the doctor if you’ve seen or experienced any of the following symptoms (even after the hospital)
- Stiff neck
- Ear or Nose drainage
- Difficulty breathing
- Bruising around the eyes
- Any form of movement restriction
- Strange eye movements
These are all symptoms that can develop later on but are essential for a correct diagnosis. The initial physician will give you a number to call if anything develops after seeing them.
How Are They Assessed?
Most doctors will assess potential brain injuries by doing a CT scan. These can diagnose any fractures, bleeding, or lesions in the brain, but they’re not perfect.
If the doctor finds nothing on a CT scan but suspects an issue, they’ll do an MRI as well. MRI’s aren’t immediately helpful, but they record things CT scans miss like matter damage.
Surgery or No Surgery?
Some brain trauma’s result in fractures or bleeding that a neurosurgeon needs to fix. These injuries are scary and brain surgery is high-risk.
In extreme cases, doctors will induce a coma to keep the brain from swelling further.
If you or a loved one are lucky enough not to need surgery, you likely won’t leave the hospital for a while.
Many brain trauma patients are kept in the intensive care unit for observation. If there’s brain swelling, it’s common for doctors to prescribe blood pressure medication.
This keeps the pressure in the brain from getting too high and vessels bursting. Or, to keep one area of swelling from putting too much pressure on another area.
The brain is very sensitive and any large changes in one lobe or cortex affect all others.
There are also treatments that can make sure enough or extra oxygen gets to the damaged brain. This makes brain tissue heal faster and keeps future swelling down.
Even after the initial danger has passed, brain injuries can flare up and cause nerve damage or injury. There is no 100% safe or effective treatment for brain trauma, it’s touchy and doctors do whatever possible to salvage the brain.
Types of Brain Injuries
The severity of brain injury depends on the severity of the trauma that caused it. Injured that come from external sources, like car crashes or sports collisions are called traumatic brain injuries.
The kind of brain trauma caused by things like strokes or more internal conditions is called acquired brain injuries. Learn about the former below.
There are three general categories of brain injuries, referred to as TBIs (Traumatic Brain Injuries).
Closed head injuries are the most common type of traumatic brain injury and the one people are most familiar with. They occur when the head moves rapidly in one or more directions, which bangs the brain against the skull.
This collision leads to bruising, swelling or bleeding in the brain.
Open Wound Injuries or penetrating brain injuries are like they sound, wounds that expose the brain. The opening can introduce germs or debris into the brain matter, increasing the risk of infection.
These wounds look scarier and more graphic than internal brain injuries, but they’re not necessarily worse. Skin is much easier to stitch up than brain tissue and most wounds aren’t problem-causing deep.
Crushing injuries generally damage the brain stem or the neck, damaging the matter through compression. In this brain injury type, something compresses the brain between two objects, like a tight squeeze.
These kind of injuries are less common, but they can happen in car accidents, like when someone needs to be cut out of a wrecked car. This type is less common, but just as serious, as the brain stem deals with most automatic body functions.
Most Common Brain Injuries
Though there are three types of traumatic brain injuries, most come from closed brain injuries. The two top types in that category are concussions and contusions. Learn the difference between the two below.
A concussion is a term we hear in sports often as a term that means a player is not coming back during that game. They’re usually ready to go as soon as the next game and we don’t think twice about it.
We should though. Concussions can be very serious things and getting a serious one, or multiple small ones has lifelong consequences.
Think about the Will Smith movie “Concussion.” In the movie, retired players have such traumatic brain functions that they kill themselves.
Doctors are still studying how little concussions over a lifetime impacts the brain.
One concussion isn’t life-ending intense, but here are some facts you need to know:
- Concussions come from hitting your head, direct blows to the head, wounds, and whiplash.
- During a concussion, the blood vessels in the brain and the cranial nerves can get damaged.
- Concussions don’t always show up on brain scans
- The symptoms are nausea, tiredness, pupil irregularity, and consciousness changes
- They are the most common brain injury
- Some take months to years to heal
If you or someone you know hits their head hard or is in a car accident, keep an eye out for concussion symptoms. It could save their life!
Even if you catch a concussion early and pursue treatment, it can still do permanent damage to your brain and impact your life.
Post-concussion syndrome is one of the most common after effects, lasting three to six months after injury. It leads to increased risk or depression and usually prolongs initial concussion symptoms.
Depression and other cognitive impairments are less diagnosable but common after a brain injury. This could be trouble remembering things, worsening pre-existing depression symptoms, or issues with hearing and nerve function.
In bad cases, concussions can lead to something called Chronic Traumatic Encephalopathy, a progressive neuron disease. It causes weakness, atrophy, and other issues similar to ALS.
Later developing conditions and lasting symptoms are why concussion patients need so much follow up care.
A contusion is essentially a brain bruise and acts like a concussion +. This upgraded concussion is more localized than a concussion and effects the lobe and functions relative to its location.
Contusions are usually caused by force, like when a car stops too quickly and the head bangs against the steering wheel. In these cases, the brain gets damaged in multiple locations.
People get contusions where the brain first hit the skull and can get a matching wound from the brain’s rebound.
There are levels of brain contusions, just like concussions. They range from very mild with low symptoms to requiring surgery.
A low-level contusion looks a lot like a concussion, in both symptoms and treatment.
For a high-level contusion, sometimes surgeons have to go into the brain and physically stop the bleeding. This can mean sewing damaged blood vessels up to removing the damaged part of the brain.
Trauma and the Brain: Long-Term Effects
If someone has a brain injury, there’s more to their treatment than immediate care. One brain injury from a car accident can change your whole life.
The after-effects of a brain injury can cause issues with basic functioning skills, like attention and memory.
People with brain injuries have trouble with paying attention, learning new material, and concentrating on one task at a time. Some become confused more easily and others need more time to transition from one task to another.
In response to this slowing, some brain injury patients don’t exercise their ability to think of multiple solutions. They get so frustrated with their thinking process that they pursue the first solution that comes to mind.
Planning is harder as well. Our prefrontal cortex (front lobe of the brain) helps us make decisions, through executive functioning.
Executive functioning is the kind of thinking ahead that makes you think “I have a busy day, so I need to pack a lunch I can eat quickly in between meetings”.
Someone experiencing post-TBI executive functioning problems is often late and has trouble making decisions for themselves or in the workplace.
Mood and Behavior
Hitting your head hard enough or having something hit it can put you in a bad mood for the rest of your life, literally. Personality is often affected following a traumatic brain injury.
People can seem absent or apathetic to their friends and family, acting unlike themselves. In other patients, rage and irritability increases, sometimes resulting in irrational behavior and abuse.
Most of the time other people notice these behavior changes. It’s unlikely the brain-injured person will see the difference. This isn’t part of the brain injury per se, it’s more denial.
They’re unwilling to admit that something bad happened to them that could change so much. It’s understandable since traumatic brain injuries are just that, traumatic.
Traumatic Brain Injuries from Car Accidents
The level of traumatic brain injury type and severity goes hand in hand with the intensity of the crash. Someone in a fender bender is more likely to get whiplash and a minor concussion, while someone who gets t-boned might get a contusion.
That’s not to say that accidents always cause brain injuries, but if you or a loved one gets in one, it’s a possibility to keep in mind.
Hopefully, you never get in a car crash that has anything but slightly-annoying consequences and you never have to use this information.
But if the worst happens and there’s a potential for brain damage, now you know how important it is to seek medical attention.
Once everything is settled at the hospital, you may be asked if you want to press charges. In this frightening time, it’s normal to be overwhelmed and unable to think about future court cases.
That’s where we come in. We’re experienced at getting car accident victims and their families back on their feet and getting them what they deserve.
Our team specializes in trauma and the brain and our empathetic team is here to help. Give us a call as soon as you feel ready, we’re waiting to hear from you.
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