Brain Injury

A brain injury is any damage to the brain that results from an external force, such as a physical blow, or internal factors, like a stroke or a tumor. The broad term “brain injury” encompasses any brain damage, regardless of the cause. Brain injuries can cause neurological dysregulation, leading to cognitive, emotional and physical problems.

Common causes of brain injuries include falls, motor vehicle accidents, sports injuries and exposure to toxic chemical agents. To prevent brain injury, people should wear protective gear when engaging in activities and sports, be mindful of potential hazards in the environment and seek medical attention for any head trauma or changes in mental functioning.

Other causes of brain injuries include: 

• Aneurysm: Brain aneurysms can cause brain damage when fluid buildup in the brain creates pressure on brain tissue and nerves. 
• Concussion: When the brain is shaken or jolted, it can cause a concussion, which can damage brain cells and cause chemical changes in the brain. Concussions can affect how your brain works and impair mental function. 
• Myoclonic disorder: This disorder can lead to brain injury when the brain is deprived of oxygen following cardiac arrest.
• Multiple sclerosis (MS): This autoimmune disorder can lead to brain damage that disrupts signal transmissions between the brain and the spinal cord. 
• Parkinson’s disease: This neurodegenerative disease affects specific brain regions, causing them to gradually deteriorate and die over time. 
• Stroke: A stroke-induced brain injury occurs when blood flow to the brain is disrupted, damaging brain cells. 

Brain injury risk factors include certain high-risk activities and age. Children under five are at risk due to accidents, as are seniors over the age of 75. Other risk factors include falls, car accidents, contact sports (like boxing, football and hockey), excessive alcohol or drug use and violence.

To prevent brain injury, individuals should avoid high-risk behaviors, like excessive alcohol and drug use and lack of protective gear during contact sports. Wearing a seatbelt while riding in a car and wearing a helmet while riding a motorcycle, skateboard or bike are all preventative measures. 
You can also protect yourself and others at home by: 

• Ensuring children’s playgrounds are made of shock-absorbing material, such as hardwood mulch or sand
• Improving balance and strength with regular physical activity programs
• Improving lighting and removing rugs, clutter and other trip hazards 
• Installing handrails on stairways
• Installing window guards and stair safety gates in homes with young children
• Using non-slip mats and installing grab bars next to the toilet and in the tub or shower for older adults

A brain injury can cause a variety of physical, cognitive and emotional symptoms that can range from mild to severe. Physical symptoms may include loss of consciousness, headaches, dizziness, fatigue, blurred vision, ringing in the ears, nausea and dystonia, a condition where a person has uncontrollable muscle movements in some part of their body. Cognitive symptoms may involve problems with memory, concentration and communication.

Diagnosing a brain injury requires a detailed physical exam and imaging test, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans, used to identify any visible damage. Your doctor may also conduct neurological tests to assess mental functioning. The need for imaging is based on a physical examination by a doctor and a patient’s symptoms.

• Computed tomography (CT) is the most commonly used imaging technology to assess people with suspected moderate to severe TBI. A CT creates a 2D image of organs, bones and tissues and can show a skull fracture or any brain bruising, bleeding or swelling.
• Magnetic resonance imaging (MRI) produces detailed images of body tissue. It may be used after the initial assessment and treatment as it is a more sensitive test and picks up subtle changes in the brain that the CT scan might have missed. Significant advances have been made in the past decade using MRI to image milder TBI damage. For example, diffusion tensor imaging can image white matter tracts, more sensitive tests like fluid-attenuated inversion recovery can detect small areas of damage, and susceptibility-weighted imaging very sensitively identifies bleeding.

Despite recent advances, currently available imaging technologies, blood tests and other measures remain inadequate for detecting these changes in a way that can help diagnose mild concussive injuries.

Treatments for symptoms resulting from brain injury are specific to each patient’s complaints and presentations. Needs and treatments may include:

• Medications (may be helpful in some circumstances to alleviate symptoms)
• Occupational therapy
• Physical therapy
• Speech therapy

Ongoing treatment and rehabilitation will help individuals recover from the effects and impact of a brain injury. It may be helpful to develop coping strategies, such as creating a routine, using memory aids, joining a support group and practicing self care by taking breaks and resting as needed.

Cognitive rehabilitation therapy (CRT) is a strategy aimed at helping individuals regain their normal brain function through an individualized training program. Using this strategy, people may also learn compensatory strategies for coping with persistent deficiencies involving memory, problem solving and the thinking skills to get things done. CRT programs tend to be highly individualized, and their success varies.

To further your understanding of your diagnosis and to contribute to cutting-edge research, consider participating in a clinical trial so clinicians and scientists can learn more about causes, symptoms, treatment and prevention. Clinical research uses volunteers to help researchers learn more about a disorder and find better ways to detect, treat or prevent disease safely.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races and ethnicities to ensure that study results apply to as many people as possible and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research, visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for participants at Clinicaltrials.gov.