I, like most people, have bumped my head or been struck in the head by something at some point. In my case this was a falling object. For most of the time these knocks have resulted in nothing more than a bruise to my head (and my ego!) but on one occasion it resulted in a concussion. Fortunately for me this resulted in nothing more than dizziness, nausea, and a noticeably short loss of memory but it could well have been a Traumatic Brain Injury (TBI), which is one of the reasons why protecting your head is ever so important.
What is a Traumatic Brain Injury?
A traumatic brain injury (TBI) is a head injury caused by a bump, blow, or jolt to the head or body or a penetrating head injury. A TBI results in disruption of normal brain function.
TBIs can occur from direct hits to the head, vehicle accidents, or inflicted injuries (like an assault or suicide attempt). They can be Industrial or Sport related for example tripping over on a construction site or hitting your head as you fall whilst playing rugby, however, the majority of TBIs occur from falls either from the same level or sometimes even higher.
Falls are the second leading cause of TBI-related deaths. When we fall or when something hits us it is not always a linear (straight) impact. Most of the time these types of impacts are oblique or angled and can cause something called a rotational brain injury. A rotational brain injury causes a sudden acceleration and deceleration of the head where the brain moves both in a linear direction and rotates within the skull. This acceleration-deceleration of the brain can result in widespread brain damage with bleeding, bruising, and swelling in the brain.
According to the National Institute for Health and Care Excellence (NICE) head injuries are the most common cause of death and disability in people aged 1–40 years in the UK. Each year, 1.4 million people attend emergency departments in England and Wales with a recent head injury. Annually, about 200,000 people are admitted to hospital with a head injury. Of these, one-fifth have features suggesting skull fracture or have evidence of brain damage. Most patients recover without specific or specialist intervention, but others experience long-term disability or even die from the effects of complications that could potentially be minimised or avoided with early detection and appropriate treatment.
The economic cost of head injuries in the UK is £15 billion a year. This figure includes the costs of lost work, of health and social care and of premature mortality.
What impact does a TBI have?
TBI’s occur on a spectrum—the most common being a mild TBI or concussion. Hitting your head on a cabinet door, falling, or getting injured playing a sport might cause one of these mild TBIs.
While you might experience pain and some neurological symptoms from a concussion, a brain scan may not show any findings like bleeding, bruising, or swelling. People who have a mild TBI or concussion usually feel better within a few weeks and in some instances sooner.
Moderate or severe TBIs, however, will show up on brain scans, usually in a variety of ways. Hematomas specifically epidural hematomas or subdural hematomas are one way a TBI can manifest. Moderate to severe TBIs can also include contusions, bruising of the brain tissue or haemorrhages both intracerebral haemorrhages and subarachnoid haemorrhages which is when active bleeding is present. TBIs can also progress from one degree to another, which is why it is so important to seek medical care if you are concerned. Some Hematomas can occur several days or even weeks following an injury to the head, so it is important to stay vigilant and monitor your symptoms.
Symptoms of a mild TBI and concussion
- Sensitivity to light or noise
- Dizziness or balance problems
- Feeling tired, no energy
- Headaches
- Nausea or vomiting (early on)
- Vision problems
- Attention or concentration problems
- Feeling slowed down
- Foggy or groggy
- Problems with short- or long-term memory
- Trouble thinking clearly
- Anxiety or nervousness
- Irritability or easily angered
- Feeling more emotional
- Sadness
- Sleeping less than usual
- Sleeping more than usual
- Trouble falling asleep
It is always a good idea to be evaluated by a medical professional after a head injury, even if it is mild. Concussions can exacerbate existing issues like migraines, motion sickness, anxiety and mood disorders. As head injuries can worsen over time, a healthcare provider’s input can also help you monitor your symptoms and impairments to make sure they are not getting worse. Seeking a healthcare provider’s input is also essential for reducing your risk of other health complications from a TBI.
Moderate and severe TBIs, however, require emergency care right away. If you have any of these “red flag” symptoms after a head injury, seek medical attention immediately.
Severe symptoms of a TBI
- Loss of consciousness for any amount of time
- A severe headache
- One pupil that is larger than another
- Dizziness
- Any type of weakness or decreased coordination
- Speech problems
- Confusion or difficulty thinking
- Seizure (shaking or twitching) for any duration
- Drowsiness or inability to wake up
- Repeated nausea or vomiting
So, to summarise head injuries can be as severe as a concussion, fractured skull, internal bleeding and damage to the brain or as mild as a bump, bruise, or cut on the head. While TBIs can result in severe medical complications, including death, knowing when to seek emergency medical care for yourself or another person can be lifesaving.
For more information, our sponsor Headway have a concussion leaflet which is available to download.