Types of Brain Injuries

The brain can be injured in a variety of ways, depending on the type and amount of force sustained by the head. A traumatic brain injury (TBI) can be caused by a blow to the head or by an object penetrating the head. In either case, it disrupts the brain’s normal functioning. Not all head injuries result in TBI. However, it is wise to seek medical advice when in doubt about the severity of the injury. Head injuries should not be taken lightly.   

Concussions are the most common type of TBI, and can be caused by direct blows to the head, gunshot wounds, violent shaking of the head or whiplash. They are common among people who play contact sports, those involved in construction accidents or automobile accidents, as well as those injured due to premises liability. Persons suffering concussions may or may not lose consciousness. If loss of consciousness does occur it usually does not exceed 20 minutes. They may also feel dazed.

A concussion is categorized as a complex neurobehavioral syndrome and may or may not include skull fractures, brain bleeding or swelling. Concussions can heal as quickly as a few months or as long as a few years. Those suffering from a concussion are at risk for possibly fatal blood clots.
Because concussions are so common, there are varying views as to treatment. Regardless of the severity of the concussion, it is imperative that the injured person seek medical care immediately so that a thorough evaluation can be made. 

Loss of Consciousness
A partial or complete loss of consciousness occurs when there is a reduction of blood flow and therefore a shortage of oxygen to the brain. This leads to a lightheadedness or “black out” episode, and is one of the clearest indicators of the brain being affected from an injury.

A contusion is a bleeding bruise to the brain (blood vessels are damaged or broken) as the result of a direct impact to the head. Contusions occur in 20 to 30 percent of severe head injuries. They usually heal on their own, but large contusions may have to be removed surgically.

Skull Fracture
A skull fracture is a break in one or more of the bones in the skull, usually occurring as a result of blunt force trauma. The force of direct impact may cause damage to the underlying physical structures within the skull, such as the membranes, blood vessels and the brain even if there isn’t a fracture.

There are four major types of skull fractures. A linear skull fracture extends through the entire thickness of the skull. With a depressed skull fracture, bone fragments are pushed below the surface of the skull, against the brain. A fracture at the base of the skull is called a basilar skull fracture, whereas one at the temple is a temporal skull fracture.
An intracranial hematoma occurs when a blood vessel ruptures within the brain or between the skull and the brain. The collection of blood (hematoma) compresses the brain tissue.

This type of hematoma may occur because the fluid that surrounds the brain can’t absorb the force of a sudden blow or a quick stop. The brain may become bruised from sliding forcefully against the inner wall of the skull. This is a serious and potentially life-threatening condition that often requires immediate treatment. It may require surgery.

Diffuse Axonal Injury
One of the most common types of TBI, this is caused by shaking or strong rotation of the head. It occurs because the non-moving brain trails behind the movement of the skull, thus leading to tears in the brain structures. There is widespread tearing of the brain’s nerve tissue, which often causes brain chemicals to be released and leads to further injury. This tearing interrupts regular communication and chemical processes in the brain. Diffuse axonal injury can produce either temporary or permanent brain damage, coma, or death.

Coup-Contrecoup Injury
Also known as an acceleration/deceleration injury, this is caused by an impact or violent motion that brings the head to a sudden stop, causing the bran to slam into the skull, causing damage. The brain is injured at the point of direct impact as well as at the opposite side of the brain.

Penetration Injury
This type of injury is caused by objects, such as a bullet, knife or other blunt item that forces hair, skin, bone and fragments from the object into the brain. Objects that travel through the skull brain at a low rate of speed can ricochet within the skull and cause a larger area of damage.
Through-and-through traumatic brain injuries occur when an object enters the skull, travels through the brain, and exits the skull. Additional effects of this kind of injury include shearing, stretching and rupturing of brain tissue.

Acquired Brain Injury
An acquired brain injury results after birth, and can be the product of a TBI, such as an accident or fall, or can be the result of a non-traumatic injury, such as a stroke or tumor. It may also be caused by medical negligence.

Types of Acquired Brain injury:
Anoxic Brain Injury

  • Caused when the brain does not receive any oxygen.
  • Anoxic Anoxia – a brain injury resulting from no oxygen supplied to the brain.
  • Anemia Anoxia – a brain injury from blood that does not carry enough oxygen.
  • Toxic Anoxia – a brain injury resulting from toxins or metabolites that block oxygen in the blood from being used.

Hypoxic Brain Injury

  • Caused by a severe decrease of oxygen supplied to the brain, even though there is sufficient blood flow.
  • Damages brain cells and the spinal cord.
  • Although this type of brain injury is relatively rare, it occurs most often before, during or after childbirth.

Causes of Acquired Brain Injury include:

  • Trauma to the head and/or neck
  • Crush injuries to the chest
  • Toxic exposure
  • Airway obstruction
  • Lightening strike or electrical shock
  • Near drowning
  • Swelling of the throat
  • Choking
  • Strangulation
  • Vascular disruption
  • Delay in delivery
  • Heart attack, stroke, arteriovenous malformation
  • Aneurysm, intracranial surgery
  • Meningitis, certain venereal diseases, AIDS, insect-born diseases, brain tumors, seizure disorders
  • Alcohol abuse, carbon monoxide poisoning, illegal drug use



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