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.
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.
It is well documented in the literature that early diagnosis and intervention of mild traumatic brain injury (mTBI) can lead to shorter recovery time.1 While mTBI/concussion is not life threatening and the majority (70–80%) of children with mTBI recover within one to three months without difficulty, some have persistent concussion symptoms lasting longer than three months,2 which may affect academic, cognitive and emotional functioning.3
Traumatic brain injury (TBI), commonly defined as "a blow or shaking to the head or a penetrating brain injury that disrupts the function of the brain," is a largely unrecognized public health problem and has long been referred to as the “silent epidemic.”1 Mild traumatic brain injury (mTBI), including concussion, is the least severe TBI and the most challenging to diagnose due to little or no visible signs of injury, reliance on self-report of symptoms, the rapid resolution of signs and symptoms, and the absence of objective evidence of a concussion on CT imaging (head CT scans do not detect concussions).2