The moments immediately after someone has hit their head are most crucial. Only a few extra minutes in delaying treatment can make a big difference. The first thing first responders or hospital staff will do when dealing with a possible brain injury, is perform a test called the Glasgow Coma Scale.
The Glasgow Coma Scale determines how serious a head injury might be. The doctor will look at a patient’s eyes studying the pupils, blinking and eye response. The doctor sometimes can tell by the eyes alone if there is a brain injury. Next they will test the patient’s verbal response if any and motor responses. With each one of these tests they will give their patient a score that determines how severe their head trauma might be.
Glasgow Coma Scale
- Score of 8 or less —- Severe Head Injury
- Score of 9-12 —–Moderate Head Injury
- Score 13 to 15——Mild Head Injury
After a doctor performs these basic tests the doctor will move on to tests that determine the severity of the injury. The only way to check a person’s head for injury is with a CT scan or an MRI Test. A CT scan uses a series of x-rays to create a detailed view of the brain. A CT scan can see fractures, bleeding, blood clots, bruised brain tissue (contusions) and brain tissue swelling. A test that uses powerful radio waves and magnets to create a detailed view of the brain, (the M.R.I.) is normally used after a patient has been stabilized. Doctors may also use an intracranial pressure monitor that can tell if the brain is swelling.
A mild brain injury may require no treatment at all other than rest, over the counter pain medicine and monitoring for any change in condition. With a moderate to severe traumatic brain injury, the focus is to keep the oxygen and the blood supply flowing and maintaining blood pressure. Doctors may also put people in induced comas so that the brain will need less oxygen that will slow the progression of injury. Sometimes, emergency surgery will be needed to minimize damage.
Types of Surgery for traumatic brain injury
- Surgery to remove a hematoma, hematomas put pressure on the brain and can damage tissue
- Repairing skull fractures or removing parts of the skull to remove pressure
- Opening a window to the skull to relieve pressure or drain fluid to create more room for the swollen tissue.
- Medication may be used after the patient is stable enough to receive them. Doctors can give patients diuretics to decrease fluid amounts in the brain and anti-seizure medicine.
Sometimes severe brain injury can leave a patient in a coma for a period of time. Patients can also have widespread damage to the brain leaving them in a vegetative state or minimally conscious. Leaving them with some self-awareness about their environment.
Patients may also suffer from other temporary to permanent disabilities including;
- blood vessel damage,
- nerve damage causing paralysis,
- Memory and functioning problems.
- Cognitive problems, social problems,
- changes in behavior,
- changes in emotional health.
- Sensory problems and may increase their risk for later degenerative brain diseases.
People who survive traumatic brain injuries will likely face extensive rehabilitation to relearn skills from walking and talking and doing everyday tasks. The goal is to improve their abilities to perform daily activities. Therapy normally begins in the hospital and continues on an inpatient rehabilitation unit or through outpatient services.