A:Traumatic brain injury (TBI) is a complex brain injury with a broad spectrum of symptoms and disabilities. The impact on a person and his or her family can be devastating. Typically TBI’s are caused by an outside force, for example, a violent blow to the head or object penetrating the skull. When TBI’s do not result in death such injuries are catastrophically disabling. According to the Center for Disease Control (CDC), TBI is a major cause of death and disability in the U.S., contributing to about 30 percent of all injury-related deaths. Those that survive a TBI can face effecting lasting a few days to disabilities, which may last the rest of their lives.
However, not all blows, bumps or jolts to the head result in TBI. The severity of a TBI is measured by a variety of factors and can range from “mild,” commonly called concussions to “severe” where there is an extended period of unconsciousness or memory loss after the injury.
Measuring the Severity of TBI A variety of measurements are taking to assess TBI due to the delicate nature of traumatic brain injury and to the differences in patient's symptoms of TBI. Glasgow Coma Scale Score, Imaging Technology and Neurological Assessment can help assess the severity, location and type of injury to the brain.
Glasgow Coma Scale Score A common method used to measure the severity of a traumatic brain injury is the Glasgow Coma Scale (GCS) score. The GCS rates a patient's level of consciousness from 3 (worst) to 15 (no impairment) based on a patient's ability to open his or her eyes, talk, and move. The GCS is typically given by a healthcare professional upon admission to the emergency room or intensive care unit. However the test does have some shortcomings. Factors such as drug use, alcohol intoxication or low blood oxygen can alter a patient’s consciousness and lead to an inaccurate GCS score.
Imaging Technology CT scans and MRI are the most common forms of imaging technology that is used to diagnosis and measure the severity of traumatic brain injury. Cranial tomography (CT) is an X-ray procedure that scans the brain and detects disorders such as bruises, blood clots, and swelling of the brain. This procedure is usually for people with moderate to severe TBI and a patient can expect to have several CT scans during the course of a hospital stay to track any lesions that were discovered.
Magnetic resonance imaging (MRI) scans are also a valuable tool in measuring the severity of TBI. MRI creates a picture of the brain based on magnetic properties of molecules in tissue. Use of an MRI might be restricted if there is any metal around the person, such as metal parts in medical devices.
It’s important to note that these technologies while informative also have their limitations in measuring the severity of TBI. It is possible to have a severe TBI and be in a coma and to have normal scan results in both CT and MRI. This is because the scans cannot detect all the types of brain injury due the the complexity of tissues in the brain.
Neurological Assessment The neuropsychological assessment is a specialized task-oriented evaluation of human brain-behavior relationships. It relies upon the use of standardized testing methods to evaluate sensory-motor processes, mathematical assessment, spatial coordination and higher cognitive functioning. Evaluations are performed by neurologist and a neuropsychologist and go into great detail to review the patient’s case history, hospital records, and acquire about how the individual was before the injury.