The sudden passing of beloved celebrity Bob Saget, who died from blunt head trauma caused by a fall, puts a new light on the dangers of a head injury and what to do in the event of sustaining one. Thomas Watanabe, MD, Director of MossRehab Drucker Brain Injury Center, talks about what happens in a brain injury, who’s at risk, and what symptoms warrant a medical visit.
What is a traumatic brain injury?
A traumatic brain injury is a sudden event that can damage the brain and affect its ability to work normally. Concussions are on the mild end of the spectrum while comas are more severe. A brain injury can be caused by a vehicle crash, fall, stroke, drug overdose, drowning, or even near-drowning or sports injury. The more severe the impact, the greater likelihood of a traumatic injury.
What happens to the brain when it is injured?
The injury sustained by Bob Saget is just one example of a traumatic brain injury. A brain injury happens in different ways. Accidents where the brain jolts violently in the skull - such as in a high-speed motor crash where the head suddenly stops - can tear groupings of small nerve fibers, called “axons”, within the brain. Alternatively, the force of an impact or blow to the head, such as from a baseball bat, can cause brain cells near the area of the trauma to die. Damage can cause problems with walking, talking, remembering and even staying awake depending on what parts of the brain are injured. A fall might result in just a bump without brain injury but can cause a more serious injury, perhaps including a skull fracture with complications such as brain bleeding. Blood brings oxygen and nutrition for the brain to properly function. If the brain bleeds, that blood is not circulating to where it needs to go. Bleeding may also increase pressure in the brain, causing swelling that reduces blood flow and damages brain cells.
What factors put people more at risk for brain damage?
If a person is on blood thinners, they are more likely to experience bleeding of the brain as a complication from brain trauma. Older people may experience more damage and not recover as well as younger people. Participants in contact sports such as football and boxing who experienced repetitive brain trauma, even if minor, may have long-term problems such as chronic traumatic encephalopathy (CTE), which is a progressive brain disease linked to a decline in memory and cognition, depression, aggressive behavior, and dementia. Second impact syndrome (SIS), where an individual suffers a second concussion before the effects of an initial one subsides, can slow recovery or cause major complications. Some people are slower to recover because they don’t rest enough to heal before resuming normal activities.
What are the signs and symptoms of a brain injury?
You can have a brain injury without any external evidence of trauma. So, you need to look for other signs. People suffering a brain injury can have a loss of consciousness if it's bad enough or just feel dizzy, appear a bit confused and/or slur words. Others suffer from a headache or can feel nauseous and vomit. Depending on what part of the brain is injured, people can develop numbness or weakness on one side of the body or face.
What steps can determine a brain injury?
There are different ways to medically evaluate a brain injury. During an exam, a physician will look for signs and symptoms, including those previously mentioned. Depending on the severity of the injury, a patient may be referred for a CT scan to spot any bleeding or internal injuries. The first step, however, is looking for evidence that the brain isn’t working quite right before further evaluation through CT imaging.
When should someone seek medical help?
If someone experiences any of the noted neurological signs and symptoms of a brain injury, they should seek immediate medical help at an emergency room. Do not wait a couple of days to see what happens. Early care decreases the likelihood of further damage to the brain from bleeding, increased pressure or other complications.
Should you avoid sleeping if you have head trauma?
In most cases, it is not necessary to stay awake for long periods of time. To be precautionary, a person who fell and hit their head but does not have any signs of a brain injury could be awakened every few hours to see if they got worse. If displaying symptoms, they should get immediate help.
Again, look for signs of weakness on one side of the body, balance problems, confusion, slurring of words, nausea, and vomiting. If you are alone and don’t feel right, go for immediate help and just don’t try to sleep it off.
What are the treatments for a traumatic brain injury?
In the past, for milder injuries, clinicians recommended that patients avoid any stimulation until they felt better. Essentially, people would often lay in bed in a dark, quiet room. Now, we know that’s not the ideal approach.
When having a mild head injury, you should give your brain a chance to rest and feel better before moving around and re-engaging in life. In most cases, this level of inactivity should only be for a day or two at most. If you continue to feel terrible, it’s time for further evaluation and treatment.
People with more severe traumatic brain injuries may need hospital treatment. Some may require surgery to relieve swelling, manage bleeding or for other reasons. Depending on the severity of injury, they may go home while others require transfer to a rehabilitation hospital to receive more intensive therapies to help them recover. Some people may need to re-learn how to walk, talk, eat or other basic activities. Treatment goals may range from getting home safely to returning to work, school, driving and other activities.
What is some general good advice to follow regarding head injuries?
It's not necessarily the most severe blow to the head that can cause brain injuries; something less impressive can still cause one. Be aware of symptoms to determine whether you need immediate evaluation. But, if you have any concerns, go ahead and get checked out.
Check out MossRrehab‘s Traumatic Brain Injury Program and the different treatments that meet ongoing needs of people who suffer a brain injury.