Traumatic Brain Injury (TBI) is a sudden brain injury, which may be caused by a jolt or blow to the head. However, there is no consistent definition of the impairment, as the specialists tend to define it depending on the circumstances. It usually happens when a heavy blow or jolt to the head leads to the damage of the brain. The nerve fibers get damaged by the collision between the brain and the skull. According to the Center of Disease Control and Prevention, it occurs when the normal functioning of the brain get disrupted by pressure from external forces. The extremity of the symptom depends on the part of the brain affected, the wide area or the extent of the damage. The effects can be physical and psychological changing the cognitive behavior of the affected person. Some of the cognitive deficits from brain injury include memory problem and amnesia, problems with judgment, loss of the sense of time and space, decreased awareness of self and others, and shortened attention span, inability to understand abstract concepts, confusion or comma.
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The general cause of unconsciousness is lack of blood flow to the brain. TBI leads to the destruction of brain tissue. The smooth flow of blood may get interrupted when the blood vessels get torn. The neuronal axons which link the brain to the rest of the body may get injured as well. This may interrupt functional communication within the brain region and between the brain and other parts of the body. At this stage, the patient loses their conscious since they are not able to respond to the surrounding.
The injury can be classified as mild, moderate or severe based on the time loss of consciousness take. If the confusion takes less than 30min, the condition is referred to as Mild TBI. Its effect is however devastating. It can also lead to disorientation, confusion, and headache. With moderate TBI the person is lethargic. Eyes can open to stimulation. Minor injury can lead to loss of consciousness for 20 minutes to 6 hours. In case of severe injury, there is a possibility of loss of consciousness for at least 6 hours or a memory loss of up to 24 hours or more.
There are different levels of impaired consciousness depending on the severity of TBI. The first one is the state of coma. Coma is the state in which the patient is completely unconscious. People who are in this state cannot respond to their surroundings, touch, pain or even sound. Their eyes remain closed, and they cannot be awakened. They are not able to communicate or respond to commands, emotions or purposeful behavior. Patients in this state are put in the intensive care unit under the life support machine.
The other state of loss of consciousness is referred to as the vegetative state. Unlike the coma, a patient in this state may be awake at times. They may open their eyes at times. They can have a brief response to touch, sound or sight. They can make facial expressions, smile or even cry. The condition is also referred to as “Unresponsive Wakefulness Syndrome.” However, despite the patient being awake at some time, they are not able to make a purposeful behavior since they are unaware of themselves and the surrounding. They are not able to communicate or follow commands. The term vegetative means that automatic functions such as breathing, digestion, and heartbeats are controlled by the brain unlike in comma where they are put under the life support machine.
The other state is the minimally conscious state. Patients in this state have started regaining their consciousness. At times they are aware of themselves or their surroundings. They may engage in purposeful behavior such as following a simple command. They can also focus on a moving object or look at the surrounding people and environment. They can try to communicate through gesture or talking or show appropriate emotions. The third state of unconsciousness is the emerged from the minimally conscious state. Patients in this state cannot communicate consistently. They are also able to work purposefully with at least two tools. Patients in this stage can respond to simple questions by giving answers such as “Yes” or “No” they are also able to perform simple instructions and conduct simple tasks.
Once the patient has regained consciousness, they get into a post-traumatic confusion state. They appear confused with some difficulty in forming new memories. They are not able to talk and may require assistance to walk. They are not able to remember what happened to them or where they were. They feel agitated a lot, feel sleepy during the day but awake during the night. At time they are aggressive and should not be left alone. They can pull the feeding or breathing tubes leading to more complications.
Loss of consciousness can lead to other accidents causing more harm to the patient since they are not able to control their behavior or the surrounding. They should, therefore, be under watch at all times. To prevent TBI and the resulting complications which include loss of consciousness, it is advisable to always take precautionary measures while engaging in activities that can lead to head injuries. A helmet should be worn at all time during construction work or when riding a motorbike or cycling.
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