Types of Brain Injury
Primarily Brain Injury: Direct injuries include skull fraction, contusions, blood clots lacerations and cutting or shearing of the nerve fibers.
Secondary Brain Injury: Secondary changes after the initial brain event can be devastating to the brain injury patient. A cascade of chemical changes can occur on a cellular level after the initial event. How well these are managed after the injury is crucial to the patient’s recovery. These changes include brain swelling, increased pressure in the brain, seizures disorders, fever and intracranial infection, hemorrhage, blood pressure disorders high or low, abnormal blood clotting, abnormal variations in carbon dioxide levels heart and lung problems and nutritional disorders.
Concussion: Concussion may be caused by any form of trauma to the head including gunshot injury, blunt trauma, whiplash, or violent shaking of the head. Patient may or may not experience unconsciousness. Concussion injuries may not always show damage on a CAT Scan.
New research strongly suggests that multiple concussions may lead to later neurological degeneration such as Lou Gehrig’s disease. After this discover researchers looked at Lou Gehrig and found evidence of at least five major concussions. Most appeared related to his head first slides into bases.
Contusion: A contusion is a bruise or bleeding from trauma to the brain. Some contusions may require surgical removal.
Coup-Contrecoup: A contusion can occur at the primary impact site but also send the brain bouncing off the opposite side creating another area of damage opposite in the brain from the original event.
Closed versus Open Head Injury: In a closed head injury, the patient skull has not been fully penetrated to expose the brain. Forty years ago patients rarely survived open head injuries. Today, thanks to advancement in emergency medicine and trauma centers many individuals can survive. However, much more rehabilitation may be needed.
Penetrating Injury: Penetrating injuries are a form of open brain injury. But more severe in many cases as bone, bullets or objects can ricochet off various tissues creating a trail of damage.
Diffuse Axonal Damage: Shearing and rupture of nerve fibers may occur as the brain is rapidly either accelerated or decelerate, causing the brain to whip back and forth ripping the fine axonal connections. Diffuse axonal can be widespread thus causing a variety of functional problems.
Acquired Brain Injury
Anoxia: In anoxia the brain fails to receive any oxygen. Within minutes severe damage may occur. This can include loss of blood supply, blood supply with lack of oxygen or metabolites or toxins blocking the use of the oxygen in the blood being delivered.
Hypoxia: In hypoxia the brain receives some oxygen but not enough to prevent some disruption. There may be a lack of blood flow or loss of blood pressure.
Types of Strokes
Ischemic Strokes: Blood clots can block the flow of oxygen and nutrients to the brain. These can occur in the brain initially as a cerebral thrombosis or may occur elsewear in the body but travel to the brain as a cerebral embolism.
Hemorraghic Strokes: This type of stroke results from the rupture of a weaked blood vessel. These may be ruptures of aneurysm or arteriovenous malformations.
Transient Ischemic attacks: Though often called mini strokes, the American Heart Association feels we should call these “warning strokes.” They represent temporary blockages in blood flow caused by small clots causing episodes of hypoxia.