A traumatic brain injury (TBI) is a blow to the head or a shaking, jarring, or jolting movement that causes stretching, swelling, or tearing of brain tissue and delicate nerve fibers. Common causes of TBI include car or motorcycle accidents, bicycle accidents, sports injuries, and falls.
A TBI can be mild, moderate, or severe. Even a mild TBI may become severe if more than one occurs within a short period. This is known as Second Impact Syndrome, or SIS. Types of brain injury include:
Concussion – temporary loss of brain function
Contusion – bruising of the brain
Hemorrhage â€“ bleeding into or around the brain
Hematoma – blood clot caused by a collection of blood in the brain
What can I expect in the hospital?
A moderate to severe TBI or a SIS is a medical emergency that requires admission to the hospital. TBI and SIS require careful observation, especially in the first 24 hours.
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
You will be checked often by the hospital staff.
A heart (cardiac) monitor may be used to keep track of your heartbeat.
Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
You may have a small tube (catheter) placed through your skull to monitor the pressure around your brain.
You may have fingersticks to check blood sugar regularly.
Your strength, ability to move, and ability to feel pain will be checked regularly.
You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
Testing may include:
Neurologic examination: Testing to check your strength, sensation, balance, reflexes, and memory. This will include looking at your eyes with a flashlight to see if your pupils are the same size.
X-rays: Pictures of the inside of the head to check for broken bones in the skull
Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the head to check for damage to your brain
Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the head to check for damage to your brain
Electroencephalography (EEG): A test which measures and records the electrical activity in the brain
The treatment for TBI depends on the location and type of the injury and how severely your brain is injured. The goal of treatment is to reduce damage to brain tissues by reducing pressure in the brain and blood pressure, as well as treating bleeding or blood clots.
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
You may receive oxygen through a small tube placed under your nose or through a mask placed over your face. In very severe cases, you may need a tube put into your lungs to help you breathe.
Your healthcare provider may prescribe medicine to:
Reduce fluid build-up in the brain and other tissues
Help you rest
Control blood pressure
You may need surgery to reduce the pressure on your brain, to control bleeding, or to remove blood clots.
You may start a TBI rehabilitation program while you are in the hospital that will help you to learn to deal with some of the functions you may have lost due to the injury. Most rehabilitation programs include:
Physical therapy to help you regain muscle strength and teach you ways to move safely
Occupational therapy to help you relearn ways to do the tasks affected by the TBI
Speech therapy to help you if you have problems with swallowing, speaking, or understanding words
Therapy may include skin care and training to help you control your bladder and bowels.
You may need help with daily activities.
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Seizure or convulsion
Trouble with muscle movements, such as swallowing, moving arms and legs
Bleeding from your ears or nose
Trouble speaking or understanding
Change in vision, such as double vision, blurred vision, or trouble seeing out of one or both eyes
Trouble staying awake or alert
Trouble thinking clearly or remembering
Unusual behavior or restlessness
Personality changes, including irritability
Increased thirst and dry mouth
Ask questions about any medicine or treatment or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with a traumatic brain injury is 3 to 6 days. If your injury is severe, you may stay in the hospital longer. You may need to go to a rehab facility to continue your brain injury rehab program before going home.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-05-01 Last reviewed: 2014-04-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Traumatic Brain Injury: References
Daroff, R, Fenichel, G, Jankovic, J., & Mazziotta, J. (2012). Bradley’s neurology in clinical practice [6th ed.]. Retrieved from http://www.clinicalkey.com
Cecil, R. L., Goldman, L., & Schafer, A. I. (2012). Goldman’s Cecil medicine (24th ed.) Philadelphia: Elsevier/Saunders
US Department of Health & Human Services. (2011) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 04/09/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp