What Causes Brain Trauma?
Frequently, brain trauma comes on very quickly and is a shock to all involved. It is most often seen as result of serious falls, automobile/motorcycle/ diving/ construction accidents, gunshot wounds, or being hit on the head. It can also be due to a stroke with or without a hemorrhage, a major seizure, or brain surgery. Anything that damages the brain is traumatic… to both the patient and loved ones. The patient’s condition can range from being slightly confused to being in a coma. Expect the unexpected when it comes to brain trauma. Maintain your hope if the injury is severe, but be realistic about the potential outcome.
How Is Brain Damage Diagnosed?
The extent of damage to the brain is diagnosed by a variety of diagnostic procedures. These include Computerized Tomography Scans (C-T Scans), Magnetic Resonant Imaging (MRI’s), or Positive Emission Tomography (PET Scans).
Priority Care Upon Injury:
The primary goal of the patient’s health care team at the time of the injury is to prevent any further damage to the brain and to maintain the patient’s vital functions, including blood pressure, heart rate, respirations, kidney function & urine output. Depending on the cause of the injury, the patient may require surgery to remove a bullet, stop a bleeding blood vessel, remove fluid or to prevent further swelling of the brain. In some cases, a portion of the skull may have to be removed to accommodate any tissue swelling (craniotomy). Your loved one may require assistance with breathing if the respiratory center of the brain has been damaged. This means that they will have a tube down their throat (endotracheal tube) or through a surgical opening made in their throat called a tracheotomy. These tubes will most likely be attached to a ventilator that will help your loved one breath. If the injury is severe enough, the ventilator may be breathing for your loved one. Do not expect your loved one to be able to talk when they have either one of these two tubes in place.
Predicting the Ultimate Outcome:
Doctors will be unable to accurately predict the actual outcome of the injury even after they have made a diagnosis. The Central Nervous System (CNS) is made up of the brain and the spinal cord. It is a very complex system. Although the cells of the CNS do not normally regenerate themselves, it is very possible for the brain to create new neural pathways and restore some function that had previously been lost. In addition, temporary swelling of the brain tissue due to the injury can last several days – several weeks, making it seem gloomier than it often ends up being. Sometimes when the swelling goes down after a few days, the patient’s condition may improve. There is no way to determine the long term effects of the injury on the patient. It is often a wait-and-see ordeal.
The one thing that the doctors don’t always tell you is that your loved one may never be the same person that s/he was prior to the brain injury. The brain controls all aspects of our being: personality, taste, hearing, vision, decision-making, emotions, speech, intellect, memory, etc. Even with the slightest of injuries, there can be subtle changes in the patient’s personality, intellectual functioning or mental state. Life with this person as you have known it has changed and getting it back to exactly where it was prior to the accident is unlikely. Once the patient is stabilized from the injury, the waiting game begins. There may be talks of discharging your loved one to a rehabilitation facility. Prior to that discharge, hospital therapists will begin aggressively working with your loved one. These team members include Respiratory, Physical, Speech and Occupational Therapists. The ultimate goal of care at this point is to get the patient back to the highest level of function as possible within the constraints of the injury.
The Frustrations of Brain Trauma:
Brain trauma of any kind can be very confusing for families and friends. Different parts of the brain may be affected, while others are intact. For example, a very intelligent person may retain his intellect after a brain trauma, but may suffer from memory loss. Others may not be able to speak, walk or remember simple things. This can be devastating to both the patient and the family. A brain trauma patient may be able to follow the news, keep up with day to day events, carry on a wonderful conversation, have a great sense of humor, and yet may lack the organizational skills needed to get things done. It is not uncommon for people to be disorganized with their calendar or preparing for events in the future. Appointments are often forgotten. The person may not be able to get their grocery list together in advance so they don’t realize when a box of cereal needs to be replenished. To the family, this may appear to be laziness or lack of planning. Dealing with this type of trauma is just as confusing and difficult for the patient. The day to day realities are very upsetting, confusing and frustrating, oftentimes resulting in anxiety and/ or depression. This can makes matters even worse if families alienate themselves from the depressed or angry patient.
Family members can experience a roller coaster of emotions ranging from frustration to confusion to anger to devastaton. They oftentimes find themselves unable to cope with the situation. They are unsure of what expectations they should have for their loved one. ” If they can do some many other things why can’t they do this? ” It brings little comfort knowing that the best neurosurgeons in the world have yet to unravel the complex mysteries of the brain. Families in such crisis should seek counseling for assistance in helping them cope. They should get as much information as they can and seek out support from professionals or from other families going through similar traumas. They need the assurance of knowing that their feelings are perfectly normal given the circumstances of their loved one’s predicament.
There are two schools of thought regarding recovery from a traumatic brain injury that appear to be in direct conflict with each other. One theory is that the patient will regain whatever lost function they are going to regain within the first 12 months after the initial injury. The other theory is that people may continue to recover function over the course of several years, with periods of plateaus & improvements. Therapies may stop during periods of improvement, but then be initiated again during periods of plateaus. The problem is that when your therapy stops during the periods of improved function, your insurance company may not want to start paying again when the need for therapy re-surfaces. You may need to fight them on this, but be prepared not to win the battle.
Reduce Your Risk of Traumatic Brain Injury:
1. Always wear a seat belt
2. Don’t text or use your phone while driving
3. Buckle your child in the car using a child safety seat, booster seat or seat belt
4. Don’t drive while under the incluence of alochol or drugs
5. Wear the proper safety gear when playing sports or other activities
6. Reduce falls in the home by making living areas safer