Types of Traumatic Brain Injury

Types of TBI

Types of TBI

A TBI can range from a mild to a severe injury. These classifications are assessed by emergency and medical personnel using the Glasgow Coma Scale, or GCS. The GCS is based on a 15-point scale that measures certain TBI symptoms associated with each level of injury. The GCS measures motor, verbal and eye responses to gauge the level of injury and chance of survival with a lower number demonstrating a more severe injury.

Different types of TBI can be caused by many different brain injuries and there are many factors to consider when determining a diagnosis. Some injuries concern the bruising and swelling of the brain, while others involve a crack or intrusion of the skull.

The following are common types of TBI:

A concussion, by itself, is one of the least serious and most common types of TBI. Many consider concussions to be “mild” TBI’s, but in reality there is no such thing as ‘mild’ when it comes to a traumatic brain injury. Concussions are trauma-induced alterations of the alert state and can result in momentary unconsciousness and lead to complications including permanent long term damage, blood clots, or death. It could take a concussion anywhere from several days to a few years to heal completely. Concussions can result from both open and closed head injuries.

Although not technically a TBI, whiplash often induces a traumatic brain injury. Whiplash occurs when the soft tissues of the neck are injured by a sudden jerking or “whipping” of the head. This type of motion strains the muscles and ligaments of the neck beyond their normal range of motion. When a vehicle stops suddenly in a crash or is struck from behind, a seat belt will keep a person’s body from being thrown forward. But the head may snap forward, then backward, causing whiplash. In addition to car accidents, whiplash can be caused by roller coasters and other amusement park rides, sports injuries, or being punched or shaken (whiplash is one of the hallmarks of shaken baby syndrome). You may feel pain and stiffness in your neck for the first few days following a whiplash injury, then feel better, only to have the pain and stiffness come back several days later. This symptom can last for months or years. The discomfort you feel may involve surrounding muscle groups in your head, chest, shoulders, and arms.

Closed head injuries are mostly caused by motor vehicle accidents or falls, and contain no penetration of the skull. In this case, the brain could have bleeding within the tissue or bruising which affects blood distribution. Oftentimes, a bruised brain will swell inside the skull, which can cause permanent damage due to the limited amount of space.

  • Contusion is a bruise or bleeding on the brain. It can result from a direct impact to the brain or from violent back and forth shaking of the brain, causing brain tissue to come into contact with blood released from broken vessels.
  • Coup Contrecoup: When a person suffers a closed head injury the brain will often rattle back and forth inside the skull, causing an injury called coup contrecoup. This type of shaking, which often occurs during automobile accidents, slams the brain against one side of the skull and then sends it on a collision course with the other side of the skull, causing more than one contusion in various parts of the brain. The primary impact is called the “coup” and the secondary impact is called the “contrecoup”.
  • Diffused axonal injury, or shearing, occurs when the brain is violently rattled back and forth, forcing the brain against the skull. If the blow is hard enough, parts of the brain can be stretched enough to tear apart. This type of injury can cause major damage to individual neurons as well as the connections between neurons, breaking down all communication between neurons in the brain. This type of disturbance can result in widespread brain damage, coma, or death.
  • Hematoma is caused by the breakage of a major blood vessel, resulting in heavy bleeding in the brain or in the area between the brain and skull.

Open head injuries occur when there is penetration of the skull, commonly from bullets or other physical objects causing a penetrating injury. These are far less common than closed head injuries, but can be very serious.

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