Orange County Neurology Medical Center
Neurologist - Brain Injury - Nerve Damage - Neurological Disorders
"Financial issues will never be an obstacle while providing our community with necessary treatment, empathy, and betterment."
Traumatic Brain Injury
Head injury; Head trauma; mild TBI; Contusion; Concussion
Defining Traumatic Brain Injury
Injury to the brain caused by and external force resulting in total or partial impairment of brain function.
The "Silent Epidemic" - Traumatic Brain Injury (TBI) occurs more frequently than breast cancer and AIDS combined, yet it is not considered a massive public-health problem. TBI is the leading cause of death in people under 45 years old, and many times is misdiagnosed or not diagnosed at all.
Trauma can be induced by:
- Concussion, the most common type of traumatic brain injury
Every year, millions of people sustain a head injury. Most of these injuries are minor because the skull provides the brain with considerable protection. The symptoms of minor head injuries usually go away on their own. More than half a million head injuries a year, however, are severe enough to require hospitalization.
Learning to recognize a serious head injury, and implementing basic first aid, can make the difference in saving someone's life.
In patients who have suffered a severe head injury, there is often one or more other organ systems injured. For example, a head injury is sometimes accompanied by a spinal injury.
The most common causes of traumatic brain injury are:
Annual incidence of traumatic brain injury in the United States alone are estimated to be 1.5 million. This number is more than breast cancer, AIDS, Multiple Sclerosis and spinal cord injury combined.
. Changes in personality, emotions, or mental abilities
Traumatic brain injury can be classified as either closed or open/penetrating.
- A closed head injury means you received a hard blow to the head from striking an object.
Additionally, brain injury can be classified as either focal or diffuse.
- Focal injury occurs in a targeted area of the brain from a direct mechanical force. Common focal injuries include contusion (bruise), laceration (tearing) and hemorrhage (bleeding).
More sophisticated classification systems have been developed to aid physicians in their diagnosis of head injury.
Concussion Grading Scale
Glasgow Coma Scale
The Glasgow Coma Scale is the most widely used grading scale to assess patients neurological status. However, there are over sixteen different grading systems that currently exist, the most recent being over ten years old. The American Academy of Neurology (AAN) is developing a new grading system that is scheduled to be introduced in 2012.
The signs of a head injury can occur immediately or develop slowly over several hours. Even if the skull is not fractured, the brain can bang against the inside of the skull and be bruised. (This is called a concussion.) The head may look fine, but complications could result from bleeding inside the skull.
Here are some of the most common symptoms for brain injury:
The following symptoms suggest a more serious head injury -- other than a concussion or contusion -- and require emergency medical treatment:
. Loss of consciousness, confusion, or drowsiness
Several types of advanced diagnostic tools are available to neurologists for the study of brain injury.
1. Neuropsychological Evaluation - a testing method through which a neuropsychologist can acquire information patient's cognitive, motor, behavioral, language, and executive functioning. This information can help guide a neurologist toward diagnosis of cognitive deficiencies and other neurological issues.
2. Magnetic Resonance Imaging (MRI) provides good contrast between the different soft tissues of the body, which makes it especially useful in imaging the brain.
3. Electroencephalogram (EEG) - useful in the diagnosis of seizure disorders, confusion, head injuries, brain tumors, degenerative diseases, infections, and metabolic disturbances that affect the brain.
4. Video Electronystagmography (VENG) - maps out the "circuitry" of the brain using infrared cameras which track the exact position and movement of the pupils in each eye. VENG is commonly used to diagnose balance issues such as dizziness and vertigo.
New Advances is Technology:
Technological advances are enabling the development of sophisticated instrumentation for neurological evaluation. While these techniques may represent the future of neurological analysis, their cost remain high thus preventing their more routine use in diagnosing brain injury.
1. MRI + Diffusion Tensor Imaging (DTI) - measures the rate of diffusion of water through the neural axons of white matter of the brain. Neurologists can study the neural pathways in the brain and compare the differences between normal patients and patients with brain injury.
2. Magnetoencephalography (MEG) - a technique for mapping brain activity by recording magnetic fields produced by electrical currents occurring naturally in the brain. Although similar to EEG which records electric fields, MEG measures magnetic fields which are distorted less than electric fields by the skull and scalp resulting in better spatial resolution.
3. Positron Emission Tomography (PET) - produces a three-dimensional image or picture of functional processes in the body by detecting pairs of gamma rays emitted indirectly by tracer. Three-dimensional images of tracer concentration within the body are then constructed by computer analysis. When used in combination with MRI and CT scans neurologist are able to evaluate both anatomic and metabolic information (i.e., what the structure is, and what it is doing biochemically).
1. Recognition - initial neurological evaluation aims to define the severity of the injury and accompanying symptoms
2. Education - counseling the patient to help them understand they are not alone. Many others in the world suffer just like them. People around them may not understand what they are going through, or others may make them feel guilty for the treatment they receive because they look healthy on the outside.
3. Pharmacological Treatment – many drugs exist to help with depression, pain, anxiety and lack of energy.
4. Head Injury Rehabilitation - restoration of functions that can be restored, and learning how to do things differently when functions cannot be restored.
5. Cranial Nerve Treatment - type of therapy to restore loss of smell, taste, sight, ability to swallow and balance
6. Symptomatic Treatment – wide variety of symptoms require help of other specialists in areas such as orthopedics, ophthalmology, psychiatry, chiropractic and more
Neurology Medical Center of South Orange County California serves patients in all South Orange County Communities including
Aliso Viejo, Capistrano Beach, Corona Del Mar, Costa Mesa, Dana Point, East Irvine, El Toro, Foothill Ranch, Irvine,
Ladera Ranch, Laguna Beach, Laguna Hills, Laguna Niguel, Laguna Woods, Lake Forest, Mission Viejo, Newport Beach, Newport Coast, Rancho Santa Margarita, San Clemente, San Juan Capistrano, Silverado, Trabuco Canyon and Tustin.
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