When patients arrive at the emergency department (ED) with a suspected head injury, clinicians need to quickly assess for severity and determine next steps. Does the patient have a brain injury—brain bleed, concussion, or both? Understanding what happens to the brain following a head injury can help determine the next steps for assessment and treatment.
Head trauma, of varying degrees, affects millions of Americans each year and results in significant morbidity rates and substantial economic costs to society. According to the Brain Injury Alliance of Connecticut, someone in the United States sustains a traumatic brain injury (TBI) every twenty-one seconds. On average, this equates to approximately 2.5 million TBI-related emergency department visits per year. Mild TBI (mTBI) is the most common type of TBI, accounting for approximately 95% of patients evaluated in the emergency department (ED) for a head injury. MTBI generally is representative of patients who report mild, non-penetrating traumatic injury associated with a brief alteration in brain function. Although mTBI is often considered an incidental and non-threatening injury, severe short and long-term effects have long been established. Additionally, there is broad acceptance that multiple mTBIs can have serious, long-term consequences.
An injury to the head is never a simple matter. Depending on the traumatic brain injury (TBI) diagnosis, it can either be mild, moderate, or severe. Thankfully, the human body has some protection from trauma, such as the human skull, which provides adequate protection for the brain inside it. According to the CDC, 70% to 90% of TBIs evaluated in the Emergency Department (ED) are considered mild traumatic brain injuries (mTBI) or concussions. As such, chances of concussion recovery are greater with early intervention. However, to obtain an objective diagnosis of concussion, patients need immediate medical attention to assess the injury’s severity.