One of the leading causes of death for people under 45 is TBI or traumatic brain injury, and the leading cause of TBI is from automobile accidents. Trauma to the brain occurs when the brain strikes the skull. The cause of the brain hitting the skull can occur from the head hitting the steering wheel, the windshield, the window or whiplash. While no blood may be visible, the injury can have lifelong effects on the victim.
When the soft tissue of the brain is smashed against the hard bone of the skull, the potential for blood vessels to tear and cause bleeding is highly likely. When bleeding happens, the blood has nowhere to go because the skull is hard and unable to expand. If the blood is not able to “bleed out” then the pressure from the blood will press on the brain tissue. Brain tissue is very delicate, and when blood builds up and presses on it, injury will occur from the pressure. It is much like when you bruise yourself. However, if the blood continues to press on the brain it may cause the portion of the brain it is pressing on to atrophy or die. If it a major part of the brain that controls breathing or heart rate perhaps, death may occur within hours of the injury. Unbeknownst to victims, a head injury may occur and the victim unknowingly seems fine. They may even get up, speak, walk around and act completely normal. However, after a time they may seem confused, slur their speech and eventually fall into a coma.
In injuries from auto accidents, an injury, which doctors refer to as “contra coup” often occurs. If the victim’s head hits the steering wheel or the windshield, the injury does not stop with the brain just hitting the front of the head. It is almost like putting apple inside a jar and shaking it. Once the head flies forward it will also fly backward, causing the brain to smash against the back of the skull bruising it. As the head flies back and forth, bruising can occur in a different part of the brain. Along with the bruising the back and forth motion can cause tearing. The tearing can be miniscule, but if torn in the wrong place it can be much like cutting a wire. These wires are microscopic and involve approximately 100 billion of these tiny “wires”. It is incredibly difficult to detect some of these tiny tears. In studies, which involve CT scans or MRI’s approximately only 10 to 15 percent of the findings were positive. Positive in a CT or MRI means that something was found to be wrong, such as a tear.
Bruising is another injury which can occur when the brain is tossed around within the skull. When you bruise your flesh, the flesh will often swell. If the brain swells however, there is nowhere for the swelling to go. When the swelling has nowhere to go it presses against the skull and damages the structures in the brain. This pressure can also cause important parts of the brain to stop functioning such as breathing or heart rate. Doctors may install a shunt or ICP (intra-cranial pressure monitor) to relief the excess pressure. If a fracture of the skull is received at the time of the accident, while this seems serious, it may consequently serve to save the life of the victim by relieving the pressure.
Injuries received from severe head trauma may result in very serious, if not life threatening, injury. Victims of severe head trauma are often left paralyzed, unable to speak or unable to breathe. Months, if not years of treatment may be necessary to rehabilitate the victim. Multiple surgeries and, at times, lifelong care may be needed. Immediate diagnosis and care is essential to the future of any patient who has suffered a head trauma due to an automobile accident.
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