Traumatic brain injuries (TBI) are all caused by physical violence, whether accidental or intentional, and all are serious. The brain is a delicate structure with a lot on its plate when it comes to human function, so even relatively minor trauma can have significant effect on the injured individual. However, there are levels of severity that have a direct impact on the prognosis of the patient.
As the term suggests, mild TBI is the least severe, and registers between 13 and 15 in the Glasgow Coma Scale.
Mild traumatic brain injury occurs when:
- Loss of consciousness is very brief, usually a few seconds or minutes
- Loss of consciousness does not have to occur—the person may be dazed or confused
- Testing or scans of the brain may appear normal
- A mild traumatic brain injury is diagnosed only when there is a change in the mental status at the time of injury—the person is dazed, confused, or loses consciousness. The change in mental status indicates that the person’s brain functioning has been altered, this is called a concussion
Moderate Traumatic Brain Injury (Glascow Coma Scale core 9-12)
Most brain injuries result from moderate and minor head injuries. Such injuries usually result from a non-penetrating blow to the head, and/or a violent shaking of the head. As luck would have it many individuals sustain such head injuries without any apparent consequences. However, for many others, such injuries result in lifelong disabling impairments.
A moderate traumatic brain injury occurs when:
- A loss of consciousness lasts from a few minutes to a few hours
- Confusion lasts from days to weeks
- Physical, cognitive, and/or behavioral impairments last for months or are permanent.
Persons with moderate traumatic brain injury generally can make a good recovery with treatment or successfully learn to compensate for their deficits.
Severe Brain Injury
Severe head injuries usually result from crushing blows or penetrating wounds to the head. Such injuries crush, rip and shear delicate brain tissue. This is the most life threatening, and the most intractable type of brain injury.
Typically, heroic measures are required in treatment of such injuries. Frequently, severe head trauma results in an open head injury, one in which the skull has been crushed or seriously fractured. Treatment of open head injuries usually requires prolonged hospitalization and extensive rehabilitation. Typically, rehabilitation is incomplete and for most part there is no return to pre-injury status. Closed head injuries can also result in severe brain injury.
TBI can cause a wide range of functional short- or long-term changes affecting thinking, sensation, language, or emotions.
TBI can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.
Repeated mild TBIs occurring over an extended period of time (i.e., months, years) can result in cumulative neurological and cognitive deficits. Repeated mild TBIs occurring within a short period of time (i.e., hours, days, or weeks) can be catastrophic or fatal.