Traumatic Brain Injury - Romatem

What is traumatic brain injury?

Traumatic brain injury can occur due to various reasons such as traffic accidents, falls from height, work accidents, assaults, and gunshot wounds. It emerges as an important cause of disability in society and its rehabilitation is also very important. After the early intensive care treatment, an intensive neurological rehabilitation program including robotic rehabilitation is needed.

Traumatic brain injury is a brain injury that results from a sudden and violent impact of the head against an object or when an object punctures the skull and damages brain tissue. It can lead to deterioration in the cognitive and physical functions of the person, resulting in thinking, perception, speech, swallowing disorders, and paralysis in organs such as arms and legs. Although it can be seen almost everywhere and at any age, its frequency is highest in young people, especially between the ages of 15-25. Motorcycle and bicycle accidents are a major cause. The use of a helmet significantly reduces the occurrence of traumatic brain injury in such accidents. Falls and non-accidental trauma in children, traffic accidents in adults, and falls in the elderly are common causes of head trauma.

What are the symptoms of traumatic brain injury?

Since the brain is the most sensitive and complex organ of the body, changes that affect the life of the person deeply can be seen in traumatic brain injuries. These changes may be cognitive changes such as memory, perception, attention, comprehension, and logical thinking, as well as physical problems such as partial or complete paralysis, balance disorders, and swallowing and speech disorders.

The mortality rate in the early stages of traumatic brain injury is quite high. Depending on the severity of the trauma, loss of consciousness, nausea, headache, neurological and cognitive effects are common. Depending on the location and extent of the brain damage, many health problems such as loss of arm and hand use, gait disturbance, sensory impairment, intellectual dysfunction, behavioral and personality changes, epileptic seizures, chronic pain, depression, bladder and bowel problems can be seen in patients. Cognitive problems such as decreased attention span, difficulty in organizing thoughts, forgetfulness, confusion, difficulties in learning new information, difficulties in reasoning and interpretation, acting inappropriately in social situations, difficulty in problem solving, decision making and planning may occur. Language problems, like cognitive problems, can differ from person to person. Difficulty in finding words, inability to form correct sentences, long and erroneous expressions, difficulty in understanding words, inability to understand different uses of words, idioms and suggestive uses, regression in reading and writing skills, and deterioration in mathematics skills are among these problems. Behavioral disorders such as personality changes, aggression, tendency to violence and loss of control may also occur as a result of traumatic brain injury. Physical limitations such as partial or complete paralysis, involuntary muscle contractions (spasticity), balance and coordination disorders, and difficulty in swallowing can reduce the functional independence of the person. These findings vary according to many factors such as the severity of the injury, the affected brain region, injuries to organs other than the brain, and pre-injury personality traits.

How is traumatic brain injury treated?

Patients with traumatic brain injury need emergency intervention and then early intervention by neurosurgery and neurology clinics. This intervention may be in the form of follow-up in the intensive care unit or surgical intervention. Providing oxygen support and adequate blood flow to the brain and the rest of the body, and controlling blood pressure are the priorities of this intervention. The patient whose medical condition has stabilized should be immediately evaluated by a physical therapy rehabilitation physician and an early rehabilitation program should be initiated. When the patient becomes eligible, it will be the best option to follow up in a physical therapy and rehabilitation clinic with specialized neurorehabilitation and robotic rehabilitation facilities.

The recovery that occurs with the disappearance of edema in the brain tissue after the early period is called spontaneous recovery. In the next period, the sprouting of nerve cells and the formation of new nerve connections contribute to the continuation of the healing. Studies have shown that neurologic recovery is greatest in the first 6 months after brain injury. However, recovery after brain injury continues rapidly for up to 2 years. In this process, a comprehensive physical therapy and rehabilitation program will maximize the patient's gains. Although recovery is faster in the first 2 years, the potential for recovery may occur in these patients in the late period. Even in patients thought to have persistent cognitive and physical impairments, some abilities can be redeveloped. For this reason, the physical therapy and rehabilitation specialist of a patient who has had a brain injury is the leader.