According to CDC statistics, approximately 214,110 hospitalizations for traumatic brain injuries (TBIs) occurred in the US in 2020. In 2023, 68,663 people died from TBIs. The data does not provide a complete overview of the situation because many TBIs are less severe. The figures leave out people who were treated and released, such as at an urgent care clinic, and people who never sought care, so the total number of brain injuries is higher. The counts also group very different conditions together. Likewise, every TBI is unique, and as such, each person's prognosis and rehabilitation regimen depend heavily on their particular injury.
Clinicians sort the category by its severity. Also, they check whether an object has either breached the skull or not. Past that, TBI categories can be based on which tissues were damaged, where blood began to pool, and how long the damage took to become apparent.
The Word Mild Does a Lot of Damage
Concussions are the least severe on the scale of traumatic brain injury. Few signs may show at the first visit, while symptoms can persist anywhere from minutes to several months.A concussion may be considered a temporary injury, according to the National Institute of Neurological Disorders and Stroke (NINDS). But not everyone follows the same timeline. There are cases where patients deal with headaches or light sensitivity. Some even have trouble finding words once the usual recovery period has passed.
Cumulative blows further complicate the situation. NINDS warns about a second hit arriving before the first injury has healed, which can leave permanent damage. Sideline protocols in youth sports exist for that reason. So does the caution a physician shows when a patient turns up after a second rear-end collision within a few months of the first.
A New Mexico firm’s rundown of 4 examples of traumatic brain injury sorts crash damage into concussion, contusion, penetrating wound, and axonal tearing. The classification matters because each one behaves differently on a scan and on a calendar.
Bruises the Brain Inflicts on Itself
Contusion, as it relates to brain tissue, refers to small hemorrhages causing swelling. It is similar to a contusion to muscles and tendons elsewhere on the body, except the physics are different. Brain tissue is suspended in liquid, meaning it floats.In an accident, it’s possible for your head to hit something. Upon impact, your head stops unexpectedly, but your brain continues to travel and suddenly hits your skull. This brain-rebounding movement results in a contrecoup injury on the opposite side of the brain, most often in the frontal or temporal lobes.
Those same forces travel down. The whip of a head that bruises frontal tissue also wrenches the cervical spine, so one collision can produce both head trauma and spinal injury. Neck and back claims of that kind, including whiplash, are among the cases handled by Fontana back and neck injury attorney Brent Duque and similar Southern California practices. One second of physics can cause two injuries, requiring two sets of specialists.
Tearing Nobody Catches on the First Scan
Diffuse axonal injury ranks among the worst outcomes of a high-speed crash and the hardest to spot early. NINDS defines it as widespread damage to the brain’s white matter that breaks down communication among nerve cells. Rotation causes it. With severe impacts, the brain twists inside the skull, and axons get stretched and snapped.Standard imaging often shows nothing. A patient can arrive alert, answer questions, and still have suffered microscopic shearing across millions of connections. Coma follows in the severe cases. Milder cases can later show up as slower thinking, irritability, and memory lapses.
Bleeding That Waits
Blood collecting inside the skull creates its own emergency, and location determines the name. Epidural bleeding sits between the skull and the brain’s outer covering. Subdural bleeding pools beneath that covering. Bleeding on the brain’s surface is known as subarachnoid hemorrhage, and intracerebral hemorrhage refers to bleeding deep in brain tissue.There are distinctive traits of brain injuries caused by bleeding that help categorize them. One type is an epidural hematoma. With this condition, patients have an initial period of unconsciousness, then seem normal, and then deteriorate rapidly as the growing hematoma presses on the brain. This sequence of events can be fatal without treatment.
With subdural bleeding, patients, especially older adults, experience chronic, slow bleeding that is often missed until they show signs of confusion. Unfortunately, people often connect this with a minor, ignored fall. More than 30% of brain injuries requiring hospitalization occur in individuals aged 75 and above. Fall injury is the reason for about half of those admissions across all ages.
Wounds That Break Through
A penetrating injury is the one that is immediately noticed. These injuries occur when an object pierces the skull and enters the brain tissue. Sharp metal fragments, broken glass, or other debris in a motor vehicle accident may cause this type of injury. The damage is often concentrated along the object's path, although bleeding and swelling can affect surrounding brain tissue.Diffuse axonal injury (DAI) occurs when sudden acceleration, deceleration, or twisting forces stretch and damage nerve fibers in different areas of the brain. There is no visible external wound, and it is harder to detect on an initial CT scan. In this case, an MRI may reveal signs of the damage. This type of injury can cause serious neurological problems.
No comments