Concept and Etiology: A traumatic brain injury occurs when there is a
sudden violent blow to the head that disrupts normal brain function.
There are two variations which include a closed injury and open
injury. An open injury occurs when there is a penetrating wound to
the head. When the brain collides with the skull it causes the brain to
bruise and damage to nerve fibres and hemorrhage can occur. (Story,
2018) These injuries can increase the risk for seizures, migraine
headaches, Alzheimer’s disease and Parkinson’s disease (Story, 2018).
Classification:
Males (nearly three times as likely as females to have a TBI)
Young children (0- to 4-year-olds) and 15- to 19-year-olds
Adults 65 years of age or older
Certain military personnel (e.g., paratroopers)
African Americans (highest death rates)
Individuals with a history of substance abuse
This disease can occur suddenly, or it can go undetected for years
depending on the severity and symptoms that an individual
experiences (Story, 2018).
Clinical Manifestations:
Indications of a concussion (e.g., amnesia, confusion, and
headache)
Changes in or unequal size of pupils
Seizures
Asymmetrical facial features
Fluid draining from the nose, mouth, or ears (may be clear or
bloody; likely CSF)
Fracture in the skull or face, bruising of the face, swelling at the
site of the injury, or scalp wound
Impaired hearing, smell, taste, speech, or vision
Inability to move one or more limbs
Irritability (especially in children), personality changes, or
unusual behavior
Loss of consciousness
Bradypnea (slowed breathing)
Hypotension
Restlessness
Lack of coordination
Lethargy
Stiff neck
Vomiting (Story, 2018)
Diagnostic Tests:
Diagnostic procedures for TBI consist of a history, physical
examination, head CT, head MRI, and ICP monitoring (Story, 2018).
Treatment strategies vary depending on the severity and the time
since injury (Story, 2018). Immediate emergency care for TBI focuses
on limiting brain damage (Story, 2018)
References
Story, L. (2018). Pathophysiology: A Practical Approach. Burlington:
Jones & Bartlett Learning.
