Traumatic brain injury (TBI) is the result of a blow to the head or body with an impulsive force transmitted to the head. These can have different severity, the mildest of which is also called concussion. Common causes of TBI include participation in contact sports, falls, motor vehicle collisions, and assaults.
Damage to the brain from TBI can be structural with direct loss of brain tissue; vascular, due to bleeding from disrupted intracranial blood vessels; or physiological, due to disruptions in the regular function of brain cells. These can result in a variety of signs and symptoms including weakness, numbness, and even coma and death. The vast majority of patients with concussion will recover fully, while those with moderate and severe TBI can have temporary or permanent disability.
Common Symptoms
- Headache
- Neck Pain
- Concentration difficulty
- Memory Loss
- Emotional Control issues
- Sleep dysregulation
- Imbalance
- Weakness
- Numbness or Tingling
- Coma
- Death
Diagnostics
Depending upon severity, diagnostic studies can include head imaging (CT or MRI), lumbar puncture, and comprehensive neurological exam. There are newer and more advanced blood tests that can help determine the difference between concussion and more severe TBI, which can be performed in most emergency room settings. For ongoing symptoms, sometimes further neuropsychological testing is indicated. All of these studies will help your provider develop a treatment plan specific to the injury.
Treatment
Most patients with concussion will recover fully with or without treatment. As overall brain function returns to normal, resolution is seen in headaches and neck pain, with cognitive and behavioral symptoms following closely. Standard treatment approaches include skilled physical therapy focused on the major symptoms of concussion: headache/neck pain, eye movement abnormalities, and gait and balance difficulty. Sometimes, medications are used to help improve symptoms during the recovery process. We often institute a gradual return program for people who require extended absences from work or school to ensure a smooth recovery.
For moderate to severe TBI, hospitalization is usually required to treat the injury and prevent any worsening. People with these types of injuries will often require extended hospital stays, followed by inpatient rehabilitation and long-term outpatient care. The recovery process can be much longer for these patients, and some disability can unfortunately be permanent.
Our Program
The Traumatic Brain Injury Program at Boston Medical Center provides consultation for inpatients and outpatients as well as a full range of diagnostic testing. Two sets of board-certified specialists care for patients with traumatic brain injuries (TBI) – one group with primarily outpatient expertise evaluates and manages patients with long-term TBI, while another with primarily inpatient expertise in neurocritical care evaluates and manages patients after discharge from the neurocritical care intensive unit at Boston Medical Center.