Emergency Neurological Conditions

Brain trauma

Brain trauma is injury to the brain caused by an external force. Most commonly, brain trauma is caused by blows to the head from motor vehicle accidents and falls. This is called “blunt” brain trauma. “Penetrating” brain trauma involves an object or missile that has penetrated the brain, usually a gunshot wound.

Blunt brain trauma causes two types of injury, focal and diffuse. Focal injury refers to a contusion, or bruise caused by the brain suddenly decelerating and banging against the hard inside surfaces of the skull. Sometimes these contusions can lead to very significant brain swelling or even a large brain bleed. Diffuse injury is cause by shearing forces on the brain after a blow or very sudden deceleration. In essence, a twisting or sheering force injures the axons, or neural connections, traveling throughout the brain. This causes the loss of consciousness, coma, memory and mood problems and cognitive loss often associated with a significant brain injury.

In most cases, brain trauma is managed with strict adherence to neurocritical care principles. That is, measures are undertaken to protect the injured brain and diminish the likelihood of further brain injury. In some cases surgery is required. Among the most common surgeries is removal of a large blood clot causing a rise in brain pressures. Another common surgery in brain trauma patients is removal of bone from the skull, and sometimes non-essential brain, in order to control brain swelling.