Understanding Management And Treatment Of Traumatic Brain Injuries, Expert Explains

According to the World Health Organization, Traumatic Brain Injuries (TBIs) are one of the major global health concerns. They can occur due to motor vehicle accidents, sports-related injuries, falls and violence. Traumatic Brain Injuries (TBIs) can be debilitating and/or fatal. Hence, it is vital to understand how doctors manage and treat traumatic brain injuries to reduce its impact, and help the victims recover well. TBIs are best handled by a multidisciplinary team comprising neurosurgeons, neurologists, physical therapy, and allied healthcare professionals.

In an interaction with OnlyMyHealth, Dr Gurneet Singh Sawhney, Senior Consultant-Neuro & Spine Surgery, Fortis Hospital, Mulund (Mumbai), explained about the process of assessment of traumatic brain injury. 

Assessment Of  Traumatic Brain Injury

The initial assessment of the TBI and the first aid administered to the victim plays a significant role after that the next course of treatment is suggested by the doctors. 

According to Dr Singh, more often victims of head trauma feel 

• Headaches
• Nausea
• Unbalanced gait
• Confusion
• Dizziness and so on. 

Doctors take care to avoid Hypotension (inadequate supply of oxygen) and Hypoxia (low blood pressure) conditions and arrange immediate hospital transfer.

When There Is No Sign Of Circulation

Cardiopulmonary Resuscitation - CPR is given if there are no signs of circulation. At the hospital, the victim undergoes various imaging tests such as Computed Tomography (CT) scans, Magnetic Resonance Imaging (MRI), and other diagnostic procedures to assess the extent of the injury, its location in the brain, and bleeding or swelling conditions if any. Based on the assessment, the patient may be put on a ventilator for breathing support or intubated.

Management Of TBI

As per Dr Gurneet, once the victim is stable after hospitalisation, the team begins treating traumatic brain injury, which can include surgery to reduce the brain damage. “Doctors administer medication for pain and to reduce the edema in the brain. They also prescribe anti-seizure medicines to prevent seizures. Surgeries to remove blood clots put pressure on the brain and damage the brain tissues, if required”, said Dr Singh. 

Surgery to treat skull fractures is done to remove the broken skull pieces and damaged tissues from the brain. In case of intracranial pressure due to skull damage, bleeding and swelling, monitoring the victim is essential. If required, a hole is made in the skull, or a shunt, or drain is added to allow the excess fluid to drain and/or relieve the pressure.

Upon recovery, the victim is advised to remain under rehabilitation which is an integral part of the recovery process of TBI. The rehabilitation programme includes occupational, physical, and speech therapy to regain the capabilities lost due to injury and improve the quality of life. Henceforth, they will also need long-term medical management to prevent complications in the future. The management protocol can include medicines to prevent seizures, manage pain, Anxiety, and/or Depression. In addition, most doctors recommend regular monitoring and medical evaluation to stay safe, avoid complications, and prevent emergencies.

Doctors recommend complete rest, slowly resuming normal activities and frequent breaks. Such patients need to avoid alcohol and drugs, which delay recovery. Also, complications such as slow healing, permanent brain damage and even death are possible in case of re-injury in such patients.  

Traumatic Brain Injuries (TBIs) can lead to severe impairment and even death. Hence, they should be promptly evaluated and treated for the best possible outcomes. Additionally, they require long-term medical care and an extensive rehabilitation regimen to improve their lives and keep long-term complications at bay.