By Bria Berry
The brain is a beautiful yet complex organ. The brain makes us who we are and is the orchestrator for the rest of our body. The brain provides us with consciousness, personality, stores memory, and allows us to make decisions and feel emotions. In addition, the brain controls the rest of our body; this includes our muscles and nerves, but also our heart, lungs, kidneys and other vital organs. Injury to the brain can impair the over 80 billion neurons that reside in our cranium and lead to dysfunction of the myriad brain functions.
Traumatic brain injury refers to an injury that disrupts how the brain works. Traumatic brain injury is common, occurring in 1.5 million Americans each year. The severity of traumatic brain is vast and ranges from mild to severe. The severity of injury is graded by several important clinical parameters including the level of consciousness and extent of motor or language dysfunction at the time of injury, and presence of post-traumatic amnesia. In addition, radiographical features such as bleeding, stroke, or diffuse axonal injury can help provide clues as to the extent and severity of injury.
Traumatic brain injury can lead to a wide range of neurological dysfunction depending on the location, severity, and mechanism of injury. Typical complaints include memory impairment, seizures, weakness, numbness, tinnitus, impaired concentration, fatigue, impaired vision, and headache. Medications and therapy can be effective in reducing the duration and severity of complaints.
While injury to the brain may have long-lasting effects, identifying who will have permanent sequelae requires a comprehensive evaluation of a multitude of factors including both clinical and radiographical parameters. Just like a bruise on the skin, brain dysfunction following a traumatic injury can be temporary or transient without permanent consequences. In other cases, the severity of injury may be sufficient to cause permanent brain injury and brain dysfunction. Finally, while recent data suggest that patients with repeated brain injury, such as professional NFL players, may be at risk for dementia or progressive cognitive decline, it remains unestablished whether isolated brain injury can result in dementia. This is an active area of research.
Traumatic brain injury is a common and diverse disorder. Only by utilizing a critical and holistic approach in the evaluation of patients with brain injury can we best provide guidance on the prognosis, management, and treatment of these patients.
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