ASK THE IU HEALTH EXPERT – Heads up: Must-know info about traumatic brain injuries – Indianapolis Recorder

March is Brain Injury Awareness Month, and there are several important things to keep in mind when it comes to treating and recovering from serious brain injuries.

What is a traumatic brain injury (TBI)?

Any injury that affects the function or structure of the brain is a traumatic brain injury (TBI). They range in severity from a very mild short-term alteration of consciousness to a devastating loss of function and even death.

How does a traumatic brain injury affect the brain and body? What changes might someone experience as the result of a TBI?

The overall effects of a traumatic brain injury are very dependent on the severity of the injury. Headache, nausea and sensitivity to light and sound are common with concussion, which is a mild TBI. More severe injuries can cause paralysis, speech problems, prolonged coma and instability of cardiopulmonary functions.

Is TBI treatable? If so, what are some of the best treatments for TBI?

Yes, TBI is treatable. Specific treatments also very much depend on the severity of the injury. In the immediate aftermath of a severe TBI, treatment is focused on prevention of swelling and preventing early complications of the brain injury and the state of coma. After this phase, rehabilitation therapies are the primary treatment of TBI.

What is the process of treating a TBI?

TBI treatments typically involve some period of rest, followed by rehabilitation therapies (physical, occupational, speech, behavioral) based on the deficits caused by the injury. Treatments for severe TBI can be life-long.

Can the brain heal from a TBI? Is there anything you can do to speed up healing? Is it possible to heal 100 percent?

Milder TBI tends to involve a more functional injury, in that the brain is not actually damaged, but is not working properly. This often heals, but repetitive injuries can make issues more permanent. In severe TBI in general, brain tissue does not heal from an injury, but a process called plasticity can allow other areas of the brain to perform tasks that the injured area of the brain used to perform. Our brains tend to lose this plasticity as we age. We are actively working in several different areas of research to try to speed up the healing process or to make that process more robust. For the severe TBI cases, the primary management revolves around preventing additional injury to the brain that occurs with swelling in the early time period after the initial injury.

What causes the brain to swell? Why is brain swelling so deadly?

Brain swelling occurs in severely injured patients due to a complex cascade of events caused by the initial injury. Inflammation and brain irritation from injured tissues, as well as the blockage of the normal flow of the spinal fluid that bathes the brain, are the primary reasons. The brain is contained inside the skull basically a box that cannot expand. Any swelling can cause significant increases in pressure, and that increase in pressure further injures the brain. Uncontrolled increases in pressure can be fatal.

How long does it typically take to recover from a traumatic brain injury?

Recovery from a TBI can be quick, as in the case of mild concussion; symptoms may be fleeting and resolve within minutes to hours. More severe injuries can be immediately life threatening. Recovery from severe TBI occurs over months, with the majority of improvement in the first six months. After six months, patients still can improve, even for a year or more. Most severe TBI, however, are left with some long-term deficits.

Are there exercises (mental or physical) that have shown success in helping the brain recover?

The brain is not a muscle. However, like a muscle, the more you use it, the better it functions, and the better it recovers from an injury.

How many traumatic brain injuries do you and your team treat in a typical year?

Our team sees and treats about 600 patients per year with TBI at IU Health Methodist Hospital. This only includes patients that actually presented to the hospital and had injuries requiring admission or observation. Many more injuries, like concussions, are treated outside of the hospital.

What kinds of experts and services does IU Health have in place to help treat patients with traumatic brain injuries?

IU Health has nationally recognized Neurosurgical and Rehabilitation services for the care of patients with TBI. IU Health Methodist houses the largest Neuro-Critical Care Unit in the country, staffed by nurses and physicians with specific expertise in neuro-trauma and other neurological disorders. We have the ability to take care of patients across the spectrum of TBI, inpatient and outpatient. We have a rapidly expanding research program as well, with the combined efforts of Neurosurgery, Physical Medicine and Rehabilitation, Psychiatry and Neuroimaging programs.

Dr. Richard B. Rodgers is an Indiana University Health Methodist Hospital neurosurgeon and director of neuro-trauma. For more information about IU Health, visit iuhealth.org. For more information about the IU Health Neuroscience Center, visit iuhealth.org/neuroscience-center.

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ASK THE IU HEALTH EXPERT - Heads up: Must-know info about traumatic brain injuries - Indianapolis Recorder