Traumatic Brain Injury: Symptoms, Diagnosis and Treatment
Symptoms of TBI
Each of the three forms of Traumatic Brain Injury display different symptoms to be aware of. Mild TBI, otherwise known as concussion, is more difficult to diagnose both in civilian life and on the military battlefield.
With mild TBI patients, full recovery can be within minutes to hours; a small percentage have symptoms that may persist months or years.
Symptoms of mild TBI include headache, dizziness, nausea/vomiting, trouble concentrating, memory problems, irritability.
Moderate TBI includes a population of patients that falls between the mild and severe spectrum. Moderate TBI patients have the most variability in the clinical presentation picture.
There is usually loss of consciousness, from an hour to a day; there can be confusion for days to weeks; and mental or physical deficits that can last months or be permanent.
The vast majority of these service members are identified and evaluated at theater-level medical facilities, and are evacuated back to the United States for further evaluation and care.
Severe TBI usually results from a significant closed head injury, as in an automobile accident or most open or penetrating injuries, where there may be considerable residual deficits of brain function.
Depending on the injury, a severe TBI could impact speech, sensory, vision and cognitive deficits including difficulties with attention, memory, concentration, and impulsiveness.
There is an aggressive initial treatment program in theater, with neurosurgical expertise.
Diagnosing and Treating TBI
The Department of Defense (DoD) is implementing an exposure screening program for all service members returning from theater. Exposures to events that carry a risk of TBI will trigger further evaluation by the screening health care provider and possibly yield a referral to a specialist. This will complement the screening program that was established by the Department of Veterans Affairs (VA). DoD and the VA are sharing this important data across the departments to ensure that care providers have all the information they need to diagnose and treat a TBI.
"While there is much ongoing research in the area of mild TBI prevention and treatment, one of the most far-reaching developments has been the educational campaign surrounding the diagnosis, the symptoms and the recovery process," said Maj. Vogt. "This has led to dramatic changes to include management of TBI in sports, especially children, an increased awareness of the problems related to multiple concussions, and improved functional outcomes of warriors with mild TBI as they have been identified and thus received treatment."
Initial focus of treating a TBI is to stabilize the injured person in order to minimize secondary complications. As a patient enters a care facility, initial medical treatment goals include ensuring proper oxygen and blood flow to the brain and body, stabilizing blood pressure, and treating any problems or conditions affecting other parts of the body (besides the brain) that have arisen because of the injury. After individuals with TBI have been stabilized, the treatment plan generally involves rehabilitation efforts to teach patients how to cope with their specific injury-related symptoms.
Depending on the severity of the TBI, a rehabilitation team may consist of:
Physical Therapists who help patients regain their coordination, flexibility, and range of motion, and to address pain and stiffness
OccupationalTherapists who help patients relearn how to perform the simple activities of daily living
Neuropsychologists, whose testing of patients' functional abilities helps the health care team identify specific areas of cognitive functioning that require specific rehabilitative efforts, and then measure progress toward addressing deficits
Psychiatrists, who help patients to better manage their cognitive, emotional and behavioral symptoms
Brain injury rehabilitation assists in reaching maximum levels of independence. Care strategies are based on the severity of brain injury. The more severe brain injuries may require a variety of approaches to care. Additional factors in dealing with TBI include patient care coordination; provider, patient and family education; and emerging medical technologies that enhance TBI care.
Each brain injury and its recovery is different, and the brain has a remarkable way to adjust after injury. It is critical to know the symptoms and to seek treatment before there is a chance for additional, more serious complications to occur. For more information about TBI, please visit Defense and Veterans Brain Injury Center.
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