This is continuation to our previous article on Traumatic Brain Injury – Symptoms and Causes, if you haven’t read through it already, you may do it now.
The diagnosis of TBI is done by measuring the impact of the injury on a Glasgow Coma Scale. The scale ranges from 3 to 15, higher the number, lesser the impact. When a person is admitted to the hospital due to a brain injury and if the person is awake, the first test done is to check if he/she is able to follow the directions of the nurse/doctor, move his/her eyes and limbs as instructed. Then the speech is tested. These can give important clues in assessing the extent of the damage that has happened.
What should you do if you happen to admit someone to a hospital with TBI?
Don’t be just an onlooker when you find someone who met with an accident and needs help. Call the ambulance and if you have witnessed the mishap, escort the person to the hospital and give the doctor all the information you know such as:
- What happened at the incident
- How did the impact happen
- What side of the head has been hit and with what
- If the person was conscious (if he/she is unconscious by the time you reach the hospital) when you found him/her.
- How much time was lapsed between the incident and admission to hospital etc.
Imaging tests are the most common ones done as a part of diagnosing brain injury including:
- Computerized Tomography Test, typically called a CT Scan. This is a series of x-rays performed on the injured site to get a detailed view of the brain. CT scan can reveal blood clots, bleeding inside the brain, bruises and inflammation of brain tissues.
- Magnetic Resonance Imaging Test (MRI Test). This test gives more detailed view of the brain. Typically MRI test is done when the person’s condition has stabilized or when there is no expected improvement after first diagnosis and treatment.
- Monitoring intracranial pressure. When there is inflammation in the brain, the swollen tissues put pressure on the blood vessels and on the skull. This can damage the brain further. A probe is inserted into the brain to monitor the pressure due to inflammation/swelling.
Treatment for Traumatic Brain Injury
Treatment for TBI depends on the severity of the injury.
Mild injuries wouldn’t warrant intensive care but a close monitoring during healing may be done. However, until the person is completely healed, he/she may be advised to avoid strenuous brain related activities and movements. He/she would be advised to rest as much as possible. Regular consultations would be advised until the doctor feels that the injury has completely healed and the person is totally fit for his/her daily routines.
In cases of severe brain injuries, the person will be admitted to the intensive care or critical care unit and made sure that enough oxygen supply is given so that the brain cells don’t die due to deprivation of oxygen. Blood pressure and cardiac rhythms are monitored continuously.
Medications will be administered depending on the need and they may include:
- Coma inducing drugs. When there is very little oxygen being supplied to the brain due to injury or damage to blood vessels, coma inducing drugs will be administered so that the brain’s requirement for oxygen drops and reduces the risk of brain cell death.
- Diuretics will be administered that will help in reducing the amount of fluids stores in tissues including those that got filled in the injury site. This helps in reducing the pressure in the affected part of the brain.
- Anti-seizure drugs. If the doctor thinks that the patient is at risk of having a seizure, anti-seizure drugs may also be given as seizures can further damage the brain.
Surgeries may also be done that will target at removing any blood clots, repairing fractures skull (removing the skull pieces that got stuck in the brain), stop bleeding in the brain, making an opening in the skull to drain the cerebrospinal fluids that got accumulated in the swollen tissues.
In order to provide the brain tissues with proper (or necessary) oxygen supply and to repair the damaged blood vessels, hyperbaric oxygen therapy may also be done as a part of treatment process. HBOT for patients with brain injury can help in supplying blood to every cell that needs it the most for functioning and to heal. HBOT can also help in regenerating new blood vessels in the brain that can supply the blood to all parts of the brain.