A traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. It can occur when there is a blow, bump, or jolt to the head. This type of injury is usually closed. A TBI can also occur when an object penetrates the skull, usually a sharp object, this condition is called a penetrating or open injury.
Symptoms of TBI can be mild, moderate, or severe. A concussion is a mild form of TBI. The effects of a concussion can sometimes be serious, but most people recover fully over time. More severe TBI can cause serious physical and psychological problems 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 and over.
- Motor vehicle accidents, this is the most common cause in young adults.
- Sports injuries.
- Hit by an object.
- Child abuse, this is the most common cause of child abuse under 4 years old.
Some common causes of penetrating injuries include:
- Hit by a bullet or shrapnel.
- Injuries from sharp weapons such as knives.
- Accidents such as explosions, natural disasters, or other extreme events.
RISK GROUPS
Men are more likely to get TBI than women, this is related to men's daily activities and hobbies that tend to be riskier, so men are also more likely to experience serious TBI. Adults aged 65 years and older are at greatest risk for hospitalization and death from TBI.
SYMPTOM
Symptoms of TBI depend on the type of injury and how serious the brain damage is. Symptoms of mild TBI may include:
- Brief loss of consciousness occurs in some cases, but many people with mild TBI remain conscious after the injury.
- Headache.
- Confusion.
- Dizzy.
- Problems with memory, concentration, attention, or thinking.
Symptoms of moderate to severe TBI include:
- Cannot be awakened from sleep or unconscious.
- Headaches that get worse or don't go away.
- Repeated vomiting or nausea.
- Seizures or convulsions.
- Slurred speech.
- 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 cause TBI, you need to seek medical attention as soon as possible. To make a diagnosis, several tests will be performed:
- The doctor will ask about the incident and symptoms in detail.
- General physical and neurological examinations, especially assessing the Glasgow Coma Scale (GCS), to assess the severity of COT, GCS has a value distribution of 3-15, 3-8 severe COT, 9-13 moderate COT, and 14-15 mild COT.
- Imaging tests, such as CT or MRI.
- Some additional tests include X-rays or laboratory examinations.
IMPLEMENTATION
Treatment for TBI depends on many factors, including the size, severity, and location of the brain injury.
- For mild TBI, the main treatment is rest. It is important to have complete rest and gradually return to normal activities. If you have a headache, you can try taking an over-the-counter pain reliever. Seek medical attention immediately if symptoms worsen.
- For moderate to severe TBI, seek immediate medical attention at an emergency services center. The first thing to do is to stabilize the condition to prevent further injury. After that, a more thorough examination will be carried out to determine the next steps. Some may require emergency surgery such as:
- Removing hematoma (clotted blood).
- Repairing skull fractures.
- Reduces pressure on the brain by draining cerebrospinal fluid.
- Medications to treat TBI symptoms and to reduce some of the risks associated with it, such as medications to reduce feelings of nervousness and fear, to prevent blood clots, to prevent seizures, to treat symptoms of depression and mood swings, muscle relaxants to reduce muscle spasms, stimulants to increase alertness and attention.
- Rehabilitation therapies, which may include therapy for physical, emotional, and cognitive difficulties, include:
- Physical therapy, to build physical strength, coordination, and flexibility.
- Occupational therapy, to help learn or relearn how to perform everyday tasks, such as dressing, cooking, and bathing.
- Speech therapy, to help with speaking 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 TBI may experience permanent disability or enter a vegetative state. TBI 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 event.
PREVENTION
There are several steps that can be taken to prevent COT:
- Always wear a seat belt when driving a car.
- Never drive under the influence of drugs or alcohol.
- Wear a standard helmet when riding a motorbike.
- Prevent falls, especially in older people with assistance.
- Making your home safer can include installing stair railings and a grab bar over the bathtub, eliminating trip hazards, and using window guards and stair safety gates for small children.
- Improve balance and strength with regular physical activity.
Article written by dr. I Gde Anom Ananta, Sp.BS (Neurosurgery Specialist, EMC Hospital, Tangerang).