SEVERE HEAD INJURY
Traumatic brain injury (TBI), a head injury, occurs when a sudden trauma causes brain damage. TBI can result from a closed head injury or a penetrating head injury. Parts of the brain that can be damaged include the cerebral hemispheres, cerebellum, and brain stem.
Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. Outcome can be anything from complete recovery to permanent disability or death.
Signs and symptoms
Some symptoms are evident immediately, while others do not surface until several days or weeks after the injury.
With mild TBI, the patient may remain conscious or may lose consciousness for a few seconds or minutes. The person may also feel dazed or not like him- or herself for several days or weeks after the initial injury. Other symptoms include:
- headache,
- mental confusion,
- lightheadedness,
- dizziness,
- double vision, blurred vision, or tired eyes,
- ringing in the ears,
- bad taste in the mouth,
- fatigue or lethargy,
- a change in sleep patterns,
- behavioral or mood changes, and
- trouble with memory, concentration, attention, or thinking
- symptoms remain the same or get better; worsening symptoms indicate a more severe injury.
With moderate or severe TBI, the patient may show these same symptoms, but may also have:
- loss of consciousness
- personality change
- a severe, persistent, or worsening headache,
- repeated vomiting or nausea,
- seizures,
- inability to awaken,
- dilation (widening) of one or both pupils,
- slurred speech,
- weakness or numbness in the extremities,
- loss of coordination, and/or
- increased confusion, restlessness, or agitation
- vomiting and neurological deficit (e.g. weakness in a limb) together are important indicators of prognosis and their presence may warrant early CT scanning and neurosurgical intervention.
Small children with moderate to severe TBI may show some of these signs as well as signs specific to young children, including:
- persistent crying,
- inability to be consoled, and/or
- refusal to nurse or eat.
Anyone with signs of moderate or severe TBI should receive immediate emergency medical attention.
Most patients with severe TBI, if they recover consciousness, suffer from cognitive disabilities, including the loss of many higher level mental skills.
The most common cognitive impairment among severely head-injured patients is memory loss, characterized by some loss of specific memories and the partial inability to form or store new ones. Some of these patients may experience post-traumatic amnesia (PTA), either anterograde or retrograde. Anterograde PTA is impaired memory of events that happened after the TBI, while retrograde PTA is impaired memory of events that happened before the TBI.