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What is TBI and how is it Treated?

A traumatic brain injury, known as a TBI, is a disruption in the normal function of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object, or when an object pierces the skull and enters brain tissue. TBIs are complex and impact each patient differently depending on the level of injury. 

How does TBI Differ from other Brain Injuries?

Dr. Gilbert Siu, who specializes in rehabilitation and is affiliated with Encompass Health Rehabilitation Hospital of Vineland, explained that the difference between traumatic and non-traumatic brain injury is how the injury occurred. “Traumatic brain injury is generally due to external force impacting the brain, such as a car accident, fall, gunshot or concussion, while a non-traumatic brain injury is an internal force affecting the brain,” he said. Examples of non-traumatic brain injury include stroke, infections, COVID-19 and brain cancer.

What Causes TBI?

According to the Centers for Disease Control, the most common causes of TBI are:

• Falls
• Firearm related injuries
• Motor vehicle accidents

Other causes can include sports-related injuries, domestic violence, combat injuries and explosions.

How is TBI Diagnosed?

To diagnose a TBI, clinicians determine the type and severity of the injury. There are several technologies and tools used to evaluate suspected TBI.

Initially clinicians will consider the symptoms and how the injury occurred. A sampling of questions used to make determinations might include:

• How did the injury occur?
• Did the person lose consciousness?
• How long was the person unconscious?
• Did you observe any other changes in alertness, speaking, coordination or other signs of injury?
• Where was the head or other parts of the body struck?
• Can you provide any information about the force of the injury? For example, what hit the person’s head, how far did he or she fall, or was the person thrown from a vehicle?
• Was the person’s body whipped around or severely jarred?

Clinicians also use imaging tests in the case of suspected TBI to take a thorough look at the brain and examine for evidence of brain bleeding (hemorrhage), blood clots, bruised brain tissue and swelling. Those imaging tests could include:

• Computerized tomography (CT) scan: A CT scan uses X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions) and brain tissue swelling.
• Magnetic resonance imaging (MRI): An MRI uses radio waves and magnets to create a detailed view of the brain. This test may be used after the person’s condition stabilizes or if symptoms don’t improve soon after the injury.

Clinicians use an assessment called the Glasgow Coma Scale to determine the level of TBI. According to the Brain Injury Institute, the Glasgow Coma Scale is designed to assess the patient’s level of consciousness after brain injury. This scale assigns numbers to eye, verbal and motor responsiveness, then adds those numbers together for a total GCS number between 1 and 15. The lower the number, the more severe the injury.

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