The most common classification system for traumatic brain injury severity is based on the Glasgow Coma Scale (GCS) score determined at the time of injury. The GCS is a 3- to the 15-point scale used to assess a patient's level of consciousness and level of neurological functioning. You or other decision-makers may need to make decisions about treatment in the first hours and days after the injury. These decisions may need to be made on the basis of unclear information.
This can be frightening and overwhelming. You may feel more confident when the diagnosis of a consciousness disorder is based on both bedside and objective tests (for example, Doctors can offer a bad prognosis “for sure. Ask questions about what this means.
More specialized bedside exams, tests, and time are often needed. This is especially important when deciding whether to remove your loved one from life support. If there is a definite negative prognosis, ask your health care team to give you the full range of possible outcomes and ask what data are the basis for the prognosis. You can also consult a disability specialist with knowledge and experience in TBI rehabilitation.
Consider what they say along with information from the health care team. These specialists can offer an expert opinion on your loved one's diagnosis and prognosis. They can also help your loved one get the right rehabilitation services. These symptoms are accompanied by understandable worry and anxiety.
This can be particularly pronounced if the patient has not been warned that these problems are likely to arise. If the patient expects to be perfectly well within a few days and the symptoms are still prominent after a few weeks, they may worry or feel guilty. This has the effect of creating a vicious cycle that leads to more symptoms, etc. A brain-dead person is not alive because all brain functions, including the brain stem, no longer work.
Symptoms of traumatic brain injury can be mild, moderate, or severe. Concussions are a type of mild traumatic brain injury. The effects of a concussion can sometimes be serious, but most people make a full recovery on time. A more severe traumatic brain injury can lead to severe physical and psychological symptoms, coma, and even death.
A traumatic brain injury can cause mild, moderate, or severe changes in one or more abilities, such as thinking, speech, physical functions, and social behavior. The consequences of traumatic brain injury can be lifelong for some people, while others may resume activities they enjoyed before the injury occurred. If an injury is severe enough, including from a concussion, the person may never function as they did before the injury. The symptoms of a traumatic brain injury can be mild, moderate, or severe, depending on the extent of the damage to the brain.
Mild cases can cause a brief change in mental status or consciousness. Severe cases can result in prolonged periods of unconsciousness, coma, or even death. It is difficult to predict how well a person who has suffered a brain injury will recover, in part because there is no test that can be done by a doctor that can reliably predict deficits and recovery. Another difficulty in diagnosing mTBI occurs in the case of complex polytrauma, where other injuries may appear more serious and the head injury is not evaluated.
Although many patients with mTBI will have normal CT findings, that doesn't mean they don't have brain injuries. Indicators of injury severity include the Glasgow Coma Scale score (15 is the least severe, 3 is the most severe) and the mechanism of injury (TBIs from motor vehicle collisions are usually more severe than other mechanisms). There are several mechanisms that can cause traumatic brain injury, which can lead to physiological or structural brain damage. National Academies of Science, Engineering, and Medicine; Division of Health and Medicine; Board of Health Care Services; Department of Veterans Affairs Examination Review Committee for Traumatic Brain Injury.
Given the complexities in diagnosing traumatic brain injury, especially mTBI, and the time that may have elapsed since the original injury, a diagnostician should be trained and familiar with the standard diagnostic tools (discussed earlier in the chapter) used to determine the injury cerebral and its severity. Recently, several studies have examined the consequences of the explosion as a new mechanism of brain injury. The committee recommends that the Department of Veterans Affairs allow health professionals who have specific traumatic brain injury (TBI) training and experience, in addition to current required specialists, to make a diagnosis of TBI. Relying on medical records is often insufficient because many injuries go untreated, including, occasionally, even more, serious injuries.
However, there are exceptions to this rule, and just as there are a small group of people who have a minor head injury who recover poorly, there is also a small group of people who have a serious or very serious injury who do exceptionally well. Mild traumatic brain injuries usually don't require treatment other than rest and over-the-counter pain relievers to treat headaches. The neurological lesion of BTBI can result from both a direct shock wave effect and an indirect transfer of the shock wave through blood vessels and cerebrospinal fluid to the brain. Doctors consider a person to be in a persistent vegetative state one year after a traumatic brain injury or three to six months after a hypoxic or anoxic brain injury.
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