Assessment and Management of Traumatic Brain Injuries
I’m Ed Smith, a Sacramento Personal Injury Lawyer. In the medical community, brain injuries are some of the most devastating injuries that someone can suffer. Because of the way the brain functions and recovers, some of those neurons that have been damaged may never regenerate. Therefore, a tremendous amount of a person’s prognosis depends on the assessment and management in the immediate period after a neurologic insult. Recently, a review of the assessment and management of traumatic brain injuries was published to enlighten patients and medical providers.
The Type of Brain Injury Matters
There are many different ways that someone could sustain a traumatic brain injury. Sometimes, people could be involved in an auto accident where they impact their head on the steering wheel, window of the car, or the dashboard. Individuals can also injure their heads in a bicycle accident if they make contact with a pedestrian and smack their head on the pavement. Regardless of how someone sustains this injury, they are serious events that should always be taken seriously; however, there are a few different types of brain injuries that vary in severity and, thus, their initial management:
Concussion: A concussion is a forceful impact to the head that is often seen while playing sports. Someone could have no symptoms of a concussion or could lose consciousness. Whether or not someone requires long-term medical care depends on the severity of the injury. Initial management typically involves some pain medication, rest, and removal of any stimulation, such as television and screens. Children may be held out of school for several days.
Epidural Hematoma: This is a serious brain injury that is often seen in a car accident. If someone smashes the side of their head on the window, this could cause a skull fracture and tear a blood vessel in the head called the middle meningeal artery. This is a serious brain injury that could be fatal if not diagnosed rapidly. The patient will likely receive some sort of brain scan and could require emergent neurosurgery to drain the blood that could be filling the patient’s skull.
Subdural Hematoma: This is a rare yet serious type of brain injury. Another brain bleed, this often happens if a patient is involved in an auto accident and is ejected through the windshield and strikes their head on the pavement. An acute tear of numerous veins in the head, this is often also diagnosed on imaging and could also require emergent neurosurgical treatment. Overall, this brain bleed has a poor prognosis.
Guidelines for Assessment and Management
The review starts with an overview of the care that patients should receive when they arrive in the emergency department. Any urgent traumatic injuries, such as massive bleeding, should be immediately addressed with IV fluids and medical care. If there is any suspicion that a traumatic brain injury has been sustained, the patient’s orientation should be reviewed. This includes orientation to person, place, time, and purpose. The patient also requires a neurological exam to review for any focal deficits such as changes in vision, hearing, motor, or sensory loss. Any suspicion of increased intracranial pressure or a brain bleed should lead to the patient receiving rapid imaging, such as a CT scan. Once the patient has been stabilized, some individuals will require critical care. This could include blood pressure medications to control the amount of flow to the patient’s brain as well as anti-inflammatory medications to reduce any swelling in the patient’s brain. This is especially important if the patient had a trip to the neurosurgical suite to address a brain bleed.
Traumatic Brain Injuries: The Next Step
Much of a patient’s outcome following a traumatic brain injury is going to depend on the initial management. While some injuries, such as concussions, may not require any emergent treatment, missing a diagnosis such as an epidural hematoma or subdural hematoma could result in a patient’s wrongful death. This is why patients who have any suspicion of an intracranial hemorrhage must receive a CT scan to rule out any type of brain bleed. If there is bleeding in the brain, this could lead to an increase in intracranial blood pressure. This is why many patients receive emergent neurosurgery to drain the bleed and relieve this pressure. If the pressure is allowed to build, this could lead to a herniation of the patient’s brainstem, leading to death. Any patient who has suffered neurological damage for any reasons could quickly accumulate expensive hospital bills and expensive insurance claims. This situation could be overwhelming for an individual, which is why patients should consider contacting an experienced legal professional for advice. They can provide assistance with insurance claims and confusing paperwork, removing much of the stress and allowing the patient and their loved ones to focus on their recovery.
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Sacramento Personal Injury Lawyer
I’m Ed Smith, a Sacramento Personal Injury Lawyer. If you or someone you know has been hurt or injured in a traumatic incident, contact me for a free, friendly consultation at (916) 921-6400 or on my toll-free line at (800) 404-5400.
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