Traumatic brain injuries (TBI) of different severity levels may cause the injured person to exhibit a varied set of symptoms. Immediately after any accident, medical attention should be sought if a TBI is suspected.
If the brain injury victim loses consciousness or seizes, even for a short time, a severe brain injury is likely and an ambulance should be called immediately. Beyond reading some of the obvious symptoms of traumatic brain injury, such as vomiting, seizures, uneven pupils, or fluid leaking from the ears or nose, determining the severity of the brain injury requires medical evaluation and treatment.
Determining the Severity of a Brain Injury with the Glasgow Coma Scale
To evaluate any potential head injury, doctors utilize a variety of tests and evaluations. Generally, an initial screening consists of a doctor asking a patient several questions about their health. If the patient is brought in unconscious or only partly responsive, triage doctors often rely on the fast and accurate Glasgow Coma Scale to assess the severity of the injury.
The Glasgow Coma Scale (GCS) is an evaluation tool used by neurologists and medical professionals to give a reliable, objective assessment of a patient’s conscious state and brain injury severity level. A brain injury patient is assessed against the criteria of the scale, and scored between 3 (deep unconsciousness, zero responsiveness) and 15 (full consciousness, fully responsive and aware). The scale includes three component tests: Eye (E), Verbal (V) and Motor responses (M). GCS results are coded with the time of day as such:
GCS 8 = E2-V3-M3 at 13:24
A GCS score of eight or less after resuscitation from the initial injury is classified as a severe brain injury. The GSC score for a moderate brain injury is between nine and thirteen. A GCS score of thirteen or greater indicates a mild brain injury, more commonly known as a concussion. People with mild brain injuries typically do not require inpatient rehabilitation unless they sustain serious trauma to other parts of their bodies.
Traumatic Brain Injury Recovery Process
Brain injury recovery continues to baffle and amaze scientists, as much is still to be learned about the mechanics of the brain and how it houses a person’s true identity. A traumatic brain injury causes damage and death of brain cells (neurons), a process called apoptosis. Unfortunately, the brain is one of the few places in the body where cells do not seem to regenerate. However, some people who suffer brain injuries still make tremendous gains in recovery. Researchers speculate that a few possibilities for the mechanisms of a healing brain may include:
- Some neurons are just bruised or swollen – but not permanently damaged. As the bruising and swelling improve, these neurons regain normal function.
- Other parts of the brain are “rewired” to take over the functions of the damaged areas.
- New connections between any remaining “reserve” brain cells may form.
Many patients can recover after a brain injury, but predicting the degree and rate of recovery is very difficult. Recovery after a brain injury goes through a series of uneven, inconsistent stages. Recovery progress can stop at one of these stages (called a plateau) and then not progress to the next stage. The transition between stages is usually very gradual. Every brain is different and each person recovers at a different pace, so it is difficult to compare the experience of one person to another.
Much of the noticeable recovery from a brain injury occurs early on, usually within the first six months after initial injury. However, most experts agree that the brain can continue to heal for up to two years after an injury. Furthermore, even after two years, people may slowly realize additional gains. The reason for this continued progress is that many of the gains after the first year or two do not depend so much on the healing of the brain, as they do on the learning of new skills.
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