What happens in a traumatic brain injury?

Brain trauma often results from a fall

31.12.2013

Traumatic brain injury is a very common injury after falling on the head. However, the severity of brain trauma can vary significantly, ranging from mild concussion to complete loss of consciousness or coma. In addition, severe traumatic brain injury often carries the risk of death.

The symptoms of craniocerebral trauma are variable depending on the severity of the injury. Headache, nausea and vomiting after a fall are to be understood as a clear warning signal here. Misalignment of the eyes (squinting), dizziness, impaired consciousness, unconsciousness and amnesia (memory gaps) are other possible symptoms of craniocerebral trauma. A particularly difficult course threatens if the cerebral hemorrhage was triggered by the fall or the force on the head. Due to the limited space in the skull, the latter increasingly presses on the brain, causing further, often fatal, complications.

Three grades of craniocerebral trauma
Depending on the severity of the craniocerebral traumata, these are subdivided into three different degrees of severity, whereby the classification is based on the so-called Glasgow coma scale. This distinguishes mild, moderate and severe traumatic brain injury (first, second and third degree brain trauma). Furthermore, a differentiation can be made in open and covered craniocerebral trauma, ie in brain injuries with externally visible open wound and brain injuries without externally visible damage. Basically, even in mild forms of traumatic brain injury hospital admission is recommended to ensure close monitoring and prompt response in the event of complications such as cerebral hemorrhage. An assessment of the severity can often be done by asking a few simple questions to those affected. Do they not remember the events, have speech disorders or even loss of consciousness, these are alarming warning signs. A timely computed tomography (CT) to detect injuries in the brain is urgently needed here.

Mild and moderate brain trauma
Brain trauma of the first degree or slight craniocerebral trauma refers to covered brain injuries in which, in addition to dizziness, nausea and vomiting, no further symptoms usually occur. After a few days, those affected have usually recovered from this concussion. The CT does not show any damage to the brain, permanent impairment is not expected, even if the patients may experience concentration problems and a significant reduction in performance over several weeks. In addition to the symptoms already mentioned, second-degree brain trauma is characterized by a prolonged unconsciousness (more than ten minutes) immediately after the event. Late effects are possible but need not necessarily follow.

Severe traumatic brain injury often with delayed effects
In third-degree traumatic brain injury (severe brain trauma), unconsciousness persists for more than 60 minutes, and bleeding and edema increase pressure on the brain. This compression often leads to a long-lasting coma and can be fatal in the worst case. To take the pressure off the brain, the skull is often opened here. Often the sufferers after healing the acute injury still long-term deficits and physical impairments, but some sufferers recover from this serious brain injury without permanent damage. The chances of a complete healing of the patients are decisively determined by the time between accident and initiation of the treatment. The individual constitution also plays a not to be underestimated role here. (Fp)