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Brain Injury 

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A head or brain injury results from a violent force to the head. A “closed head injury” occurs from blunt trauma such as hitting a head on a car dashboard. A penetrating head injury occurs when the brain is pierced by an object, such as depressed bone fragments or a bullet.

A traumatic brain injury (TBI), also called acquired brain injury, occurs when a sudden trauma causes damage to the brain

Two of the most common types of brain injury are concussions and contusions, a bruise on the brain. Common causes of head injury include traffic accidents, falls, physical assault, and accidents at home, work, outdoors or while playing sports.

Symptoms
Learning to recognize a serious brain injury and implementing basic first aid can make the difference in saving someone's life.

The signs of a brain injury can occur immediately or develop slowly over several hours. Even if the skull is not fractured, the brain can be bruised, known as a concussion. The head may look fine, but complications could result from bleeding inside the skull.

The following symptoms suggest a more serious brain injury -- other than a concussion or contusion -- and require emergency medical treatment:
Loss of consciousness, confusion or drowsiness
Low breathing rate or drop in blood pressure
Convulsions
Fracture in the skull or face, facial bruising, swelling at the site of the injury or scalp wound
Fluid drainage from nose, mouth or ears (may be clear or bloody)
Severe headache
Initial improvement followed by worsening symptoms
Irritability (especially in children), personality changes or unusual behavior
Restlessness, clumsiness, lack of coordination
Slurred speech or blurred vision
Inability to move one or more limbs
Stiff neck or vomiting
Pupil changes
Inability to hear, see, taste or smell

Swelling from a brain injury usually continues for 72 hours and then begins to resolve. It can take weeks to assess the long-term damage following a brain injury.

Diagnosis
Assessing brain damage is a long-term and continuous process that involves a number of medical professionals. It begins immediately after the injury has occurred, and may continue throughout rehabilitation, which could last anywhere from several months to a year.

Tests to determine the extent of the brain injury could include CT scans, MRIs and X-rays.


Treatment
Pressure in the brain due to swelling is serious because the brain is contained within the hard shell of the skull and cannot expand beyond it. Too much pressure can crowd and damage critical structures, including those that govern breathing and heart rate. In some cases, an intra-cranial pressure (ICP) device is inserted to measure pressure changes.

Neurosurgery for head trauma or a brain injury  is dependent on the extent of the skull fracture, the amount of blood that has collected in the brain -- and the extent to which these factors have impacted the neurological examination. It could involve craniotomy for removal of blood clots in the brain tissue, bone fragments or foreign objects.

Medical management is used to reduce the effects of a brain injury. This supportive care may include medications, oxygen support, IV therapy and rehabilitation services.

Once a patient has been stabilized, long-term rehabilitation is an important part of recovery. The patient will be assigned a team of therapists to help recover pre-injury abilities or to teach how to compensate for any functions that have been lost or permanently altered from the brain injury. Family members can be extremely helpful in assisting with rehabilitation.

Since our brain defines who we are, a brain injury can affect all aspects of our lives, including our personality. Therefore, a change in brain function can have a dramatic impact on family, job, social and community interaction.

Prevention
Most head or brain injuries are the result of accidents. The best form of prevention is to take precautions.

Do not dive without knowing the depth of an area
Drive carefully and always wear your seatbelt 
Make sure to wear a helmet when cycling and roller blading, skateboarding.
Use age-appropriate car seats or boosters for babies and young children
Make sure children safe play areas
Supervise children of any age
Do not drink and drive, and do not allow yourself to be driven by someone who you know or suspect has been drinking alcohol. 

Resources
The Brain Injury Association of America
MedlinePlus 
National Institute of Neurological Diseases and Stroke
Head Injury Association 
Brain Trauma Foundation 

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