Traumatic brain injury (COT) is a sudden injury that causes damage to the brain. This can happen when there is a blow, bump, or jolt to the head. This type of injury is usually closed. A COT can also occur when an object penetrates the skull, usually by a sharp object, this condition is called a penetrating or open injury.
COT symptoms can be mild, moderate, or severe. Concussion is a mild type of COT. The effects of a concussion can sometimes be serious, but most people make a full recovery over time. More severe COT can cause serious physical and psychological disorders such as coma and even death.
REASON
Some common causes of closed head injuries include:
- Falls, this is the most common cause in adults aged 65 years and over.
- Motor vehicle accidents, this is the most common cause in young adults.
- Sports injuries.
- Being hit by an object.
- Child violence, this is the most common cause of children under 4 years old.
Some common causes of penetrating injuries include:
- Hit by bullets or shrapnel.
- Injury by a sharp weapon such as a knife.
- Accidents such as explosions, natural disasters, or other extreme events.
RISK GROUP
Men are more likely to get COT than women, this is related to men's daily activities and also hobbies that tend to be more risky, so men are also more likely to experience serious COT. Adults aged 65 years and over are at the greatest risk of being hospitalized and dying from COT.
SYMPTOM
COT symptoms depend on the type of injury and how serious the brain damage is. The symptoms of mild COT can include:
- Brief loss of consciousness in some cases, but many people with mild COT remain conscious after the injury.
- Headache.
- Confusion.
- Dizzy.
- Problems with memory, concentration, attention, or thinking.
The symptoms of moderate to severe COT include:
- Cannot be awakened from sleep or unconscious.
- Headache that gets worse or doesn't go away.
- Repeated vomiting or nausea.
- Seizures or seizures.
- Talk lisp.
- Weakness or numbness in the arms and legs.
- Loss of coordination.
- Increased confusion, restlessness, or agitation.
DIAGNOSIS
If you have a head injury or other trauma that may have caused COT, you need to get medical treatment as soon as possible. To make a diagnosis, several tests will be carried out:
- The doctor will ask about the events and symptoms in detail.
- General physical and neurological examination, especially assessing the Glasgow Coma Scale (GCS), to assess the severity of COT, GCS has a distribution of 3-15 values, 3-8 severe COT, 9-13 moderate COT, and 14-15 mild COT.
- Imaging tests, such as a CT or MRI.
- Some additional tests are in the form of X-rays or laboratory examinations.
MANAGEMENT
Treatment for COT depends on many factors, including the size, severity, and location of the brain injury.
- For mild COT, the main treatment is rest. It is important to take complete rest and return gradually to normal activities. If you have a headache, you can try taking over-the-counter pain relievers. Get checked out immediately if the symptoms get worse.
- For moderate to severe COT, immediately go to the emergency service center. The first thing that will be done is to stabilize the condition to prevent further injury. After that, a thorough further examination will be carried out to find out the next steps. Some may require emergency surgery, such as:
- Removing a hematoma (clotted blood).
- Repairing skull fractures.
- Reducing pressure on the brain by draining cerebrospinal fluid.
- Medications to treat COT symptoms and to reduce some of the risks associated with them, such as: anti-anxiety drugs to reduce feelings of nervousness and fear, anticoagulants to prevent blood clots, anticonvulsants to prevent seizures, antidepressants to treat symptoms of depression and mood instability, muscle relaxants to reduce muscle spasms, stimulants to increase alertness and attention.
- Rehabilitation therapy, which can include therapy for physical, emotional, and cognitive difficulties, including:
- Physical therapy, to build physical strength, coordination, and flexibility.
- Occupational therapy, to help learn or relearn how to do everyday tasks, such as dressing, cooking and bathing.
- Speech therapy, to assist with speech and other communication skills and treat swallowing disorders.
- Psychological counseling, to help learn coping skills, improve relationships, and enhance emotional well-being.
- Skills counseling, which focuses on the ability to return to work and face challenges in the workplace
- Cognitive therapy, to improve memory, attention, perception, learning, planning, and judgment.
- Some people with COT may experience permanent disabilities or enter a vegetative state. COT can also lead to the risk of other health problems such as anxiety, depression and post-traumatic stress disorder, which can occur months after the incident.
PREVENTION
There are several steps you can take to prevent COT:
- Always wear a seat belt when driving a car.
- Never drive under the influence of drugs or alcohol.
- Wear a helmet that conforms to standards when riding a motorcycle.
- Prevent falls, especially in the elderly with assistance.
- Making your home safer, for example, you can install railings on stairs and handrails in bathtubs, eliminate tripping hazards, and use window guards and stair safety gates for young children.
- Improve balance and strength with regular physical activity.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgeon Specialist at EMC Hospital Tangerang).