Traumatic brain injury – Diagnosis and treatment – Mayo Clinic

Diagnosis

Traumatic brain injuries are usually emergencies and consequences can worsen rapidly without treatment. Doctors usually need to assess the situation quickly.

This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person's ability to follow directions and move their eyes and limbs. The coherence of speech also provides important clues.

Abilities are scored from three to 15 in the Glasgow Coma Scale. Higher scores mean less severe injuries.

If you saw someone sustain an injury or arrived immediately after an injury, you may be able to provide medical personnel with information that's useful in assessing the injured person's condition.

Answers to the following questions may be beneficial in judging the severity of injury:

Tissue swelling from a traumatic brain injury can increase pressure inside the skull and cause additional damage to the brain. Doctors may insert a probe through the skull to monitor this pressure.

Treatment is based on the severity of the injury.

Mild traumatic brain injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. However, a person with a mild traumatic brain injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms. He or she may also have follow-up doctor appointments.

The doctor will indicate when a return to work, school or recreational activities is appropriate. It's best to limit physical or thinking (cognitive) activities that make things worse until your doctor advises that it's OK. Most people return to normal routines gradually.

Emergency care for moderate to severe traumatic brain injuries focuses on making sure the person has enough oxygen and an adequate blood supply, maintaining blood pressure, and preventing any further injury to the head or neck.

People with severe injuries may also have other injuries that need to be addressed. Additional treatments in the emergency room or intensive care unit of a hospital will focus on minimizing secondary damage due to inflammation, bleeding or reduced oxygen supply to the brain.

Medications to limit secondary damage to the brain immediately after an injury may include:

Anti-seizure drugs. People who've had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury.

An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Continued anti-seizure treatments are used only if seizures occur.

Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems:

Most people who have had a significant brain injury will require rehabilitation. They may need to relearn basic skills, such as walking or talking. The goal is to improve their abilities to perform daily activities.

Therapy usually begins in the hospital and continues at an inpatient rehabilitation unit, a residential treatment facility or through outpatient services. The type and duration of rehabilitation is different for everyone, depending on the severity of the brain injury and what part of the brain was injured.

Rehabilitation specialists may include:

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

A number of strategies can help a person with traumatic brain injury cope with complications that affect everyday activities, communication and interpersonal relationships. Depending on the severity of injury, a family caregiver or friend may need to help implement the following approaches:

Jan. 17, 2018

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Traumatic brain injury - Diagnosis and treatment - Mayo Clinic