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Overview

A traumatic brain injury can cause problems in memory, cognition, language and motor skills. The brain is the most complex, delicate and well-protected structure in the human body—wrapped by the skull and layers of tissue called meninges. Despite all of this insulation, traumatic brain injuries are still common, affecting as many as 3 million Americans per year. 

With skilled and timely treatment, patients can recover and maintain a good quality of life. At Yale Medicine, our doctors create an individualized treatment plan for each patient. 

"It's one thing to save a person's life, but another to provide state of the art care that has the potential to lead to improved functional and neurologic recovery," said Emily Gilmore, MD, a Yale Medicine neurologist. 

What is traumatic brain injury?

Traumatic brain injury results when an outside force, like a car crash, causes the brain to rock back and forth inside the skull. It can also happen if an external force breaks the bones of the skull and penetrates the brain tissue.

Traumatic brain injury can cause irreversible brain damage, so it is crucial that patients seek medical care immediately after a brain injury. Highly trained physicians can help patients stabilize the injury, promote brain healing, and prevent additional injuries.

What are the different types of traumatic brain injury?

There are several types of traumatic brain injury. The most common ones include:

  • Concussion: Concussions are the most common types of traumatic brain injury. A concussion is caused when the brain receives trauma from an impact or a sudden momentum or movement change. The blood vessels in the brain may stretch and cranial nerves may be damaged. It can take several months to a few years for a concussion to heal.
  • Contusion: A contusion is a large bruise in the brain.
  • Coup-Contrecoup: A coup-contrecoup is when the impact on a person's head is so strong, it knocks the brain into the other side of the skull and causes bruising on both sides.
  • Diffuse Axonal: A diffuse axonal injury occurs when brain structures shear and cause the release of brain chemicals. 
  • Penetrating: This type of brain injury occurs when a bullet, knife or other sharp object lodges in brain tissue. 

What are the symptoms of traumatic brain injury?

Symptoms can be severe and alarming, prompting patients to seek immediate medical attention. Brain injury can sometimes cause spinal fluid to leak from the ears or nose, loss of consciousness, or pupils that are dilated or unequal.

Respiratory and balance problems as well as difficulty with memory, language, muscle coordination and bowel or bladder control are also common. But brain injuries that cause less-severe symptoms still require immediate medical attention, too. These lesser symptoms include: headache, nausea/vomiting, ringing in the ears, numbness and changes in behavior.

How are brain injuries diagnosed?

Many brain injuries are treated with brain rest, which simply means taking a break from physical and mental activities until the brain has enough time to heal. Brain rest could last for weeks or months, depending on the severity of the injury. Some brain injuries, such as penetrative injuries and contusions, might require surgery to remove objects or treat bleeding and swelling. 

How are brain injuries treated?

Many brain injuries are treated with brain rest, which simply means taking a break from physical and mental activities until the brain has enough time to heal. Brain rest could last for weeks or months, depending on the severity of the injury. Some brain injuries, such as penetrative injuries and contusions, might require surgery to remove objects or treat bleeding and swelling. 

What are the long-term risks of repeat brain injuries?

Repeated traumatic brain injuries can lead to a progressive, degenerative disease called Chronic Traumatic Encephalopathy (CTE), which is linked to dementia and depression. Researchers from Boston University found that brain tissue of professional athletes with CTE exhibit brain degenerating patterns similar to patients with Alzheimer’s disease.

This devastating condition can severely affect patients’ quality of life: They might suffer from hallucinations, emotional disturbances, memory problems, learning difficulties, muscle spasms and motor control issues.

Is there a connection between brain injury and other neurological conditions such as post traumatic stress disorder (PTSD) and epilepsy?

Early research indicates that people who have experienced traumatic brain injuries are more likely to suffer from other complications. In one study, Yale University researchers examined United States veterans from Iraq and Afghanistan, finding that veterans, who had experienced combat-related concussions were more likely to suffer from post-traumatic stress disorder (PTSD) and PTSD-related symptoms. A more recent study that also evaluated veterans from Iraq and Afghanistan found an association between epilepsy and traumatic brain injury. More research is needed to understand the connection between brain injury and other neurological conditions. 

How is Yale Medicine's approach to treating brain injury unique?

Patients at Yale Medicine are treated by a multidisciplinary team of specialists that can address each symptom of brain injury. Neurointensivists, who are physicians trained in critical care neurology, assess brain function and work closely with neurosurgeons  to manage severe brain injury and brain swelling in the early phases of acute injury.  Throughout a patient’s hospitalization, neurologists  work in concert with nurses, therapists, psychiatrists, specialists in physical medicine and rehabilitation (also called physiatrists), cognition specialists, and a dedicated pain management team. "This collaborative approach allows us to provide patient driven care guided by each individual’s specific needs," Dr. Gilmore said. 

Patients also benefit from cutting-edge clinical research. Even though there is currently no known method of regenerating nerve cells once they are damaged, a team of scientists at Yale’s Center for Neuroscience and Regeneration Research is working to restore function to damaged nerves, hoping to reverse the damage, thus paving the way for future treatment and even cure of traumatic brain injury.