There is often curiosity surrounding the distinctions between traumatic brain injuries and other neurological damage. Brain damage can manifest in various ways, and a brain injury resulting from trauma differs somewhat from other types of cognitive impairments. For instance, some individuals may endure brain damage due to dementia, while others may face developmental deficits stemming from persistent seizures associated with epilepsy.

A traumatic brain injury refers explicitly to neurological damage caused by a traumatic event. In such cases, an external force impacts the individual’s skull, damaging the delicate brain tissue. Trauma can inflict various types of damage upon the brain tissue, including:

• Cerebral Contusion: The traumatic force knocks the brain into the skull. If the skull suddenly stops, such as when the head strikes the dashboard, the brain continues to move inside the skull and collides with the hard surface. This can create a bruise on the brain, just as in other areas of the body.
• Spinning Forces: A traumatic event can take place from a violent spinning motion. If the brain spins at high speeds inside the skull, it can “shear” or tear the neurons, creating brain damage. This type of injury is referred to as diffuse axonal injury.
• Pressure Damage: Bleeding and brain swelling creates a form of pressure damage. The brain is encased in the skull, meaning the space it occupies is set. If bleeding occurs inside the skull, the blood takes up space and squeezes the brain. This can lead to something called a herniation, a brain injury with severe consequences.

Brain bleeding can give rise to a condition known as herniation, which involves displacing a portion of the brain across different structures within the skull. This occurs when extra fluid or pressure accumulates, often in the form of blood, within the cranial cavity.

During a herniation, the brain is forced to shift and compress against the skull structures; the affected brain tissue is typically subjected to irreversible damage. Various types of herniations can occur, including:

• Tonsillar Herniation: A tonsillar herniation results when the cerebellar tonsils, a portion of the cerebellum, protrude through the foramen magnum (where the brainstem typically exits). When this happens, the cerebellar tonsils compress the upper part of the spinal cord, known as the cervical region. This injury results in skyrocketing blood pressure, a plummeting heart rate, cessation of breathing, and places the patient into a coma.
• Subfalcine-Cingulate Herniation: This herniation results when brain tissue under the falx (in the middle of the brain) is displaced to one side. This leads to an extreme headache, small pupils, and paralysis of the leg on the opposite side of the herniation. This is the most common type of herniation.
• Uncal Herniation: In this herniation, the medial portion of the temporal lobe pushes through the posterior fossa, placing pressure on the middle part of the brainstem. The pupil on the same side of the herniation becomes dilated, and the eyes become paralyzed. The body’s opposite side from the side herniated side becomes markedly weaker. Patients typically fluctuate in and out of consciousness.

In cases where imaging studies like CT scans and MRIs reveal bleeding within the cranial cavity, skilled neurosurgeons can take prompt action to prevent the occurrence of herniation. Temporary removal of a portion of the skull is performed to facilitate the natural release of pressure from blood accumulation and brain swelling.

The removal of the skull allows the brain and cranial cavity to expand, as the head is no longer confined by the rigid skull structure. This temporary measure enables the bleeding to cease and the brain tissue to subside from swelling. Once the necessary healing has occurred, the skull can be carefully repositioned without risk of herniation or its associated complications.

Groundbreaking research has revealed a promising connection between lithium, a widely used treatment for bipolar disorder, and its potential to safeguard neurons in traumatic brain injury cases. During such injuries, the release of glutamate, an amino acid and chemical signal, poses a significant risk of neuronal damage, some of which may be irreversible.

Studies have indicated that lithium could potentially inhibit the release of glutamate, thereby protecting neurons from harm. This novel application of a well-established medication holds considerable promise. However, further investigation is required to fully comprehend its effectiveness in aiding individuals who have suffered brain injuries in traumatic accidents. Nonetheless, this development offers hope for those grappling with some of the most devastating injuries one can experience.

The video below discusses how traumatic brain injuries are treated with new technology and treatments.