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.