Brain Injury

What is Brain Injury/Trauma?

The effects of brain trauma vary widely: minor brain trauma requires no or only outpatient treatment. Intensive care and an operation are required in case of a severe injury, and brain trauma can even be fatal with injuries of the most severe nature. As different as the effects are, all versions are summarised under the term brain trauma.

The causes are varied. In principle, a force acts on the skull and this injures the brain. This occurs frequently in traffic accidents or falls - people of all ages can therefore be affected.

The brain is the command centre for the whole body. It is complex network of nerves and tissues which perform all manner of functions such as regulating our organs, allowing us to think, talk, move and see. It does this automatically in rapid time. However, when something goes wrong to the brain, such as an injury, the results can be life changing and permanent. The prognosis depends upon the cause, nature and location of the brain injury. There are two types of brain injury: traumatic and acquired.


Types of Brain Injury

Traumatic brain injury

Traumatic brain injury - is where an external force has hit the head, often through a fall, a vehicle accident or violence. Brain injury can be caused primarily by the sudden impact to the head and then secondarily due to the complications that arise following the injury such as a bleed on the brain or a rise in the pressure of the fluid surrounding the brain (hydrocephalus). The secondary effects contribute massively to the damage from the initial injury.

Acquired brain injury

Acquired brain injury – an acquired brain injury includes all types of brain injuries that are not hereditary, congenital or degenerative but are caused after birth by a loss of oxygen to the brain (hypoxia) and cerebral vascular accidents (stroke). Alcohol and drug abuse, cardiac arrests, and infections would also come under this category.

Birth

Birth – a lack of oxygen to the brain before birth (perinatal hypoxia) is a prevalent cause of brain injury in infants. When the brain is deprived of oxygen, damage can occur to the cells. The level of brain injury depends greatly upon the lack of oxygen and duration of the lack of oxygen, greatly differing the effect it can have on the child.

Additionally, perinatal illness, genetic or congenital disorders, a traumatic childbirth and a very premature birth can give rise to brain injuries.

Disease

Disease – There are numerous diseases that can lead to brain injury. Examples are: brain tumours, whereby the tumour can compress nerves and brain tissue leading to damage; neurodegenerative diseases such as multiple sclerosis, Parkinson’s disease and Alzheimer’s are conditions whereby the brain cells deteriorate.


What are the consequences of Brain Injury/Trauma?

The classification according to the Glasgow Coma Scale (GCS) has been established to determine the severity of brain trauma. 13-15 points indicate minor, 9-12 points moderate and 3-8 points severe brain trauma. Combined with further neurological examination results, the value that is determined provides a clear prognosis for the patient. Whether what is known as whiplash trauma without the direct exertion of force on the skull can cause a brain injury and actually constitutes brain trauma is frequently discussed.

When the nervous system is impaired as a result of brain trauma, this affects the mobility of the body, sometimes in the long term. Occupational and physiotherapy combined with orthoses or also functional electrical stimulation helps relearn certain movements or as far as possible compensate for limitations.