What are some prognosis for Brain Injury?

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Prognosis

The prognosis of TBI often depends on the severity of the MBA, on the attention that an individual received upon injury and on the severity
of the injury. It is difficult to predict the outcomes of TBI, one can be in a coma, severely injured and not expected to walk or talk
again and walk out of the hospital and be fine, while another could have mild injuries and suffer much more from their TBI and have
more complications. Please remember that what is being discussed here is only medical literature that are suggestions of ways to
predict one’s prognosis after a TBI. The brain is the most complicated part of our body and there is much about it that we still do
not understand. Doctors are constantly discovering new things about the brain and each injury is different and unique. What may have
been an accurate prediction of one’s outcome based on assessments, scans and the Glasgow Coma Scale, may not be an accurate prediction
for another.


Studies have suggested that there are a couple of factors that can help predict one’s outcome after a TBI and these factors are used
in many hospitals:
A) The Glasgow Coma Scale (GSC) score within six hours of admission. This is the most common one and often the
most accurate one.
B) Neuroassessment (assessments of the brain and brain functioning) that are not reflected within the GCS
C) Mechanism of injuries (how one was hurt and where they were injured)
D) age of patient
E) the relationship of the multiple injuries and how complicated they are and which takes precedent.
For example if there are live threatening injuries, those will be treated first and dealt with.
Sometimes this means that complications in the brain could arise, since the injuries to the brain may not have been
as life threatening as the crushed lung.
F) CT Scans and MRI’s
G) Length of coma and stay in hospital.
Most individuals with a moderate brain injury will survive a hospital stay and do report upon discharge memory loss, difficulty
with daily living and some struggles.
Some can have complications with their minor head injuries also. They may report headaches, memory deficits and some issues
with cognitive functioning (how one’s mind is now working.)


If an individual is admitted to a hospital with more severe injuries and has a severe brain injury, they often are admitted to the
Intensive Care Unit. If complications are to arise, many of them tend to be hypoxia, hypertension, delay in treatment and seizures.
These are often termed as secondary conditions, since they do not happen upon initial injury, but afterwards and can lead to a
secondary brain injury and poor outcomes. In some cases, an individual may have been in a motor vehicle collision and upon impact there
was not a brain injury, but as a result of the life threatening injuries that they received upon impact, there is complications as
mentioned above while in the emergency room or intensive care and this leads to a brain injury, which can be known as a secondary
brain injury.


There are prevention methods that the staffs are aware of and they monitor the individual to prevent hypoxia or hypertension and
seizures. The biggest concern that many doctors and staff have is swelling of the brain. If the brain swells, then this can lead to
further injury and complications. Once the brain injury has been diagnosed, then staff will do all that they can to reduce swelling.
Sometimes this can be a shunt (tube) that has been placed in the skull to reduce swelling and to release pressure. Some doctors believe
in hypothermia treatment in order to reduce swelling and to bring the pressure down. Seizures are also very serious and fluid/drugs can
be given to prevent seizures.


There are two types of head injury, closed head injury which means that the skull has not been cracked open and all of the swelling
and bleeding is internal, which is serious for that can lead to swelling of the brain and our skulls do not have room for the brain to
swell. This form of TBI can be more serious in the fact that it is not as easily diagnosed and can be harder to diagnosis. This is
when CT scans and MRI’s can be very helpful in order to have a better idea as to what is going on in the brain.


The second type of injury is open head injury which speaks for itself, the skull has been cracked open and it is obvious that there is
an insult to the brain. Medical staff will be faster to treat this form of injury and there is not always swelling of the brain upon
impact, but that can happen at a later date. One of the biggest concerns with this form of injury and what medical staff will try to
prevent is infection to the brain. If an infection develops in the brain, this can and will lead to further complications and injury.


What the overall conclusion is that the most effective treatment of TBI is prevention. Prevention to avoid being in a motor vehicle
collision and prevention of a secondary brain injury, whether it be to reduce swelling, prevent infection, prevent seizures and to do
all that one can do to help the brain heal and get better.