Treatment
It is important to seek immediate medical attention, whether the injury seems mild or severe, to monitor vital functions and to treat potential life-threatening symptoms. The required treatment depends on the severity of the injury. To determine the extent of the brain injury, CT scans (computed tomographic) and MRI scans are performed to create a detailed view of the brain.
Mild injuries may be treated with medication and should be closely monitored at home for any new or worsening symptoms.
Mild injuries may be treated with medication and should be closely monitored at home for any new or worsening symptoms.
Medical Treatment - Prescribed Drugs
Surgical Treatment
If necessary, surgery is used to reduce intracranial pressure (ICP) in those with severe traumatic brain injuries. To protect the healthy brain tissue, oxygen and blood products may be administered. The goal of a surgical treatment is to prevent secondary injury by decreasing swelling and intracranial pressure and increasing blood flow and oxygen to the brain.
Bleeding and hematomas can be surgically removed or drained, and crushed blood vessels can be repaired through neurosurgery. Neurosurgery is an invasive treatment used to control bleeding inside the brain, repair damaged tissue, and control intracranial pressure (ICP). Brain tissue that has extensive brain damage may need to be surgically removed. Craniotomy, surgery that involves removal of part of the skull, may be needed to repair skull fractures and remove bone pieces.
Bleeding and hematomas can be surgically removed or drained, and crushed blood vessels can be repaired through neurosurgery. Neurosurgery is an invasive treatment used to control bleeding inside the brain, repair damaged tissue, and control intracranial pressure (ICP). Brain tissue that has extensive brain damage may need to be surgically removed. Craniotomy, surgery that involves removal of part of the skull, may be needed to repair skull fractures and remove bone pieces.
Recovery Time
Recovery time has improved due to improved surgical techniques, monitoring devices, rehabilitation, and medication. However, every individual and case is different so not everyone recovers at the same rate. Recovery from a traumatic brain injury depends on the severity, location, age, and general health of the individual.
Recovery time for a mild TBI usually takes between 3-6 months, with the first 3 months being the most rapid. Symptoms lasting longer than 6 months are likely to improve within a year post-injury. Individuals under the age of 40 recover more quickly and those over the age of 40. For those over 40, full recovery for a mild TBI can take 6-12 months.
Recovery time for a severe TBI can take years, and hence rehabilitation is used to help train the brain and restore neuron function. Rehabilitation may be needed for years post-injury, and may even be a lifelong process. For some cases of TBI, individuals may never fully recover. Symptoms may be permanent and disabilities arise. Common disabilities include cognitive, sensory processing, communication, behavioural, and mental problems. Severe injuries can also result in a coma for more than a month.
Recovery time for a mild TBI usually takes between 3-6 months, with the first 3 months being the most rapid. Symptoms lasting longer than 6 months are likely to improve within a year post-injury. Individuals under the age of 40 recover more quickly and those over the age of 40. For those over 40, full recovery for a mild TBI can take 6-12 months.
Recovery time for a severe TBI can take years, and hence rehabilitation is used to help train the brain and restore neuron function. Rehabilitation may be needed for years post-injury, and may even be a lifelong process. For some cases of TBI, individuals may never fully recover. Symptoms may be permanent and disabilities arise. Common disabilities include cognitive, sensory processing, communication, behavioural, and mental problems. Severe injuries can also result in a coma for more than a month.
Adjunctive/Alternative Treatment
The goal is to help the return to everyday life.
Physiotherapy Physiotherapy focuses on improving physical and motor function by working to improve muscle coordination, strength, flexibility, endurance, and balance. It helps treat abnormal and spastic muscle tone. Functional goals of physiotherapy involve increasing independence in walking, getting up from a chair or toilet, getting out of bed, etc. Physiotherapy also assesses the need for a wheelchair, brace or cane.
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Occupational therapy Occupational therapy focuses on overcoming physical challenges to help improve quality of independent life. Occupational therapists help to increase motor and visual skills, and cognitive ability, help learn, relearn, and improve daily life skills, and help to improve muscle coordination and function, and restore lost functional ability.
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Neuropsychology Neuropsychology focuses on improving cognitive thinking processes, behaviour, and emotional processing. Neuropsychologists conduct detailed assessments to help the return to normal life.
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Risks or concerns of the above-mentioned therapies:
Adult brains are not as capable of establishing new brain pathways and relearning skills as the brains of children. Permanent residual damage may be present in certain areas of the brain that inhibit motor and sensory skills, and can cause permanent disability.
It is important to take note the possibility of a seizure due to increased irritability around scar tissue in the brain. It is important to adapt the treatment plan towards the needs of the individual, as they may be experiencing fatigue, frequent headaches, and memory loss.
It is important to take note the possibility of a seizure due to increased irritability around scar tissue in the brain. It is important to adapt the treatment plan towards the needs of the individual, as they may be experiencing fatigue, frequent headaches, and memory loss.
Gould, B. E., & Dyer, R. M. (2011). Pathophysiology for the Health Professionals (Fourth ed., pp. 494-498). St. Louis, MO: Jeanne Olson; Saunders Elsevier Inc.
Werner, R. (2013). A Massage Therapist's Guide to Pathology (Fifth ed., pp. 201-203). Philadelphia: Lippincott Williams & Wilkins.
Werner, C., & Engelhard, K. (2014). Pathophysiology of traumatic brain injury. British Journal of Anaesthesia, 99(1), 4-9. doi:10.1093/bja/aem131
NINDS Traumatic Brain Injury Information Page (2014, July). In Traumatic brain injury: Hope through research. National Institute of Neurological Disorders and Stroke. Retrieved November 23, 2014, from http://www.ninds.nih.gov/disorders/tbi/tbi.htm
Traumatic Brain Injury: Hope through research. National Institute of Neurological Disorders and Stroke (n.d.). In Center of Excellence for Medical Multimedia Virtual Library. Retrieved November 23, 2014, from http://www.traumaticbraininjuryatoz.org/Moderate-to-Severe-TBI/Treatment-Stages-of-Moderate-to-Severe-TBI/TBI-Medication-Chart