Caring for Catastrophic Injuries to the Brain or Spine

At Norton Neuroscience Institute, we’re committed to caring for patients who’ve suffered some of the most devastating injuries — those affecting the brain, spinal cord or peripheral nerves. Our team of neurological trauma specialists uses the most advanced treatments and therapies in caring for these injuries, with the goal of minimizing the damage and giving the patient the best possible chance of returning to a full and active life.

Approximately 500,000 people experience brain or spine injuries every year in the United States. These injuries usually are caused by car accidents, falls, sports, recreation or violence. Brain and spinal cord injuries are serious injuries that must be treated quickly and aggressively. The first step in treatment is evaluation or assessment of the injury. Following diagnosis, surgery may be required to relieve bleeding or pressure on the brain or spinal cord. Medications also may be administered to help lower pressure.

Traumatic Brain Injury

Traumatic brain injury — also called brain injury or head injury — may happen when there is a blow to the head, such as from a fall, car accident or sports injury. The result of the impact is damage to the brain. Traumatic brain injury also can occur from a penetrating injury, such as a gun or knife wound. This impact can bruise the brain and cause bleeding.

There are different types of brain injury, so damage and prognosis for recovery usually depend on the area of injury and how much damage was caused. If you’ve suffered a mild traumatic brain injury, you may be treated in a hospital emergency room and released. More serious brain injuries can cause disability or death. That’s why every traumatic brain injury should be evaluated as quickly as possible.

Types of Traumatic Brain Injury

Several types of traumatic brain injury can occur after head trauma:

• Concussion – The most common type of traumatic brain injury, this is an injury to the head that may cause an immediate loss of awareness or alertness for minutes or even hours.
• Contusion – A bruise to the brain that causes bleeding and swelling
• Diffuse axonal injury – Damage from shearing or tearing of brain tissue, usually from the impact of a car accident
• Penetration injury – An object enters the skull and damages brain tissue.
• Skull fracture – A break in the skull bone. There are four major types:
  • Basilar – The most serious type of skull fracture, it involves a break in the bone at the base of the skull.
  • Depressed – This fracture may occur with or without a cut in the scalp. Part of the skull is actually sunken in from the trauma.
  • Diastatic – Fractures occur along the suture lines in the skull (areas between the bones in the head that fuse together during childhood).
  • Linear – This fracture is a break in the bone without the bone moving. This is the most common type of skull fracture.
• Subarachnoid hemorrhage – Bleeding in the area between the brain and the thin tissue that covers it. This area is known as the subarachnoid space.
• Subdural hematoma – Blood collects on the surface of the brain. An acute subdural hematoma happens when a head injury causes bleeding, which rapidly fills the brain and causes brain damage. A chronic subdural hematoma may go unnoticed for some time after a minor head injury.

When a traumatic brain injury occurs, there may be mild to severe changes in thinking, speech, movement, personality or other areas. Prompt diagnosis and care may help in recovery. Our neurological specialists will run tests on the brain to diagnose physical changes and the extent of damage these changes may have caused.

Treating Traumatic Brain Injury

The brain controls every thought, behavior and movement, so a traumatic brain injury can have serious consequences. It’s critical that it be evaluated as quickly as possible to determine the severity and extent of the injury, and begin treatment.

Severe brain injuries need emergency treatment to keep damage from getting worse. Following an injury to the brain, there may be swelling and bleeding. Since space inside the skull is limited, this can put increased pressure on the brain. Surgery, medication, rehabilitation or a combination of all three may be needed to treat a traumatic brain injury.

Types of Surgery

• Shunt: A tube placed in the brain to relieve fluid buildup and reduce swelling in an effort to restore normal function to brain cells.
• Skull fracture repair: While many skull fractures heal on their own, they are surgically repaired if they are causing additional pressure on the brain.
• Skull opening: Surgeons create an opening in the skull if pressure cannot be relieved in any other way. This area remains open until the swelling has gone down.
• Blood clot removal: Blood clots that are trapped between the skull and the brain are removed to help reduce pressure and prevent more damage.

For more information about brain injury services, call Norton Neuroscience Institute at (502) 394-6390 or (800) NEURO-KY.

Care That’s Focused on You

It’s part of Norton Neuroscience Institute’s goal to care for the whole person, not just the condition.

• Norton Neuroscience Institute Resource Centers offer ways to improve your access to care, provide valuable information on managing your disease and address your quality-of-life issues. The Norton Healthcare Foundation funds this important service, so patients don’t need to pay.
• Dedicated patient navigators can help schedule follow-up appointments, coordinate prescription assistance, create customized diet plans and provide guidance on disability benefits, housing, financial and employment concerns, and more.
• Patients can access support groups, exercise classes and other educational events to connect with others and learn how to make the most of life while managing a neurologic condition. 
• Access an on-demand video library of educational content across a variety of condition-related topics.
• We want to help prevent illness. Get help quitting smoking and learn the signs of stroke.
• Communicate with your provider, manage appointments, refill prescriptions and more anytime from a computer or mobile device with a free Norton MyChart account.

A Louisville Leader in Neurologic Care

More patients from Louisville and Southern Indiana seek their neurology and neurosurgery care from Norton Neuroscience Institute’s nationally recognized specialists than any other providers in the area.

Your Norton Neuroscience Institute medical provider has the expertise, experience, diagnostic tools and sophisticated treatments to provide care tailored to your needs.

• More than 75 medical, surgical and research specialists are dedicated to providing innovative care to those with brain, spine and nervous system conditions.
• Advanced, minimally invasive neurosurgery equipment can speed your recovery and minimize pain.
• Multidisciplinary clinics provide easy access to care in one convenient appointment for your neurologic condition, with specialists in oncology, cardiology, orthopedics and behavioral health.
• Norton Healthcare’s four adult-service hospitals in Louisville are certified by DNV, recognizing excellence and expertise in stroke care.
  • Norton Brownsboro Hospital is recognized as a Comprehensive Stroke Center.
  • Norton Audubon Hospital and Norton Hospital are Primary Stroke Centers.
  • Norton Women’s & Children’s Hospital is an Acute Stroke Ready Hospital.
• Norton Neuroscience Institute is at the forefront of neuroscientific research. As investigators on numerous trials, our physicians contribute to groundbreaking studies and publications in peer-reviewed journals. Also, patients may be eligible to take part in these experimental treatments. Learn more about current neuroscience clinical trials and studies.
• The American Heart Association Get With the Guidelines stroke care program has recognized Norton Hospital and Norton Brownsboro Hospital in Louisville for exceeding national averages in getting patients in the door and administering lifesaving treatment to restore blood flow to the brain.
• Norton Neuroscience Institute’s multiple sclerosis (MS) program has been designated a Center for Comprehensive MS Care by the National Multiple Sclerosis Society.
• The National Association of Epilepsy Centers has recognized Norton Neuroscience Institute Comprehensive Epilepsy Center as a Level 4 center, providing the highest level of medical and surgical evaluation and treatment for patients with complex epilepsy.
• Norton Neuroscience Institute Resource Center navigators help educate patients and their families about new diagnoses, available treatments and ways to manage their disease.
• We are listed by Becker’s Hospital Review as one of 100 great neurosurgery and spine programs.