Ultimately, there are two types of traumatic brain injuries: those that occur without penetration into the skull or brain matter, or other injuries that involve the invasion of an object that physically enters the skull and the cranial cavity.
For most people, it is much easier to understand the latter because there is a visible indication of injury that blatantly suggests a problem. When there is no visible cut or laceration, we rely on behavioral symptoms as well as various medical tests that might illustrate the type and severity of a traumatic brain injury. For part one of this discussion, we’ll explore what happens when there is an open head injury – those that are made obvious by wounds or an invasive object, like a bullet, sharp tool, or some other type of weapon.
Fast moving objects, like a bullet, can often create a shock wave effect that causes profound injury along the trajectory path of entry.
Perhaps one of the most apparent issues when dealing with an open head injury is bleeding. Even if the injury does not penetrate the skull, our scalps are laden with thousands of blood vessels. Even minor cuts can create a significant amount of bleeding, which can be quite scary, but most of the time, minor skin lacerations will stop bleeding on their own. Sometimes, more severe cuts might require stitches, staples, and treatment with a mild coagulant to help clot the injury and stop the bleeding.
When someone experiences perforating head injury (one that penetrates through the skull) there are a plethora of concerns that a doctor might have.
The skull varies in thickness and depending on the exact location of the injury itself, the trauma could result in numerous bone fragments that could cause additional damage. These sharp remnants can penetrate the brain matter and become lodged – creating yet another issue that exacerbates the initial injury.
An intracranial hematoma is the term used to describe bleeding that occurs within the brain. This type of diagnosis can be alarming for a number of reasons. Not only does it allow blood to seep into the brain matter itself, but it can hinder the vital flow of blood to other areas of the brain. Anticoagulants are usually not a safe treatment in this case because they could result in additional clots that may lead to a stroke. When doctors are unable to control an intracranial hematoma, they will perform surgery and cauterize, or burn, the vessels that are bleeding profusely.
Another concern of an open head injury that results in a skull fracture is potential infection. Once that barrier has been broken, germs and bacteria can easily enter into this cavity and result in harmful, even deadly infection. Extra care must be taken to ensure that an open head injury is kept clean.
Finally, if the penetrating object is still present, a brain surgeon will need to remove it. If that object is serving as a temporary block to a major bleed, removing it can be very scary.
Although most open head injuries point directly to the primary areas of concern, various imaging tests may be performed to verify the severity and help doctors choose the best treatment options available. In minor injuries, a CT, or computed tomography scan may be performed to verify any damage to the skull or facial bones. This form of imaging is essentially an advanced type of x-ray. A magnetic resonance imaging test, or MRI, is best used to diagnose problems of the soft tissue. Whenever there is concern about damage to the brain itself, an MRI is the best choice of testing because it takes priority over a skull fracture. Both of these tests may be performed with or without contrast dye to develop a more precise image of the brain and possible injuries within.
Be sure to follow up with Types of Traumatic Brain Injury: Part Two for more information about closed head TBI.
You should also find our article: Understanding the Basics of Brain Injury Starts With Anatomy to be very helpful.
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The car accident and personal injury lawyers at Martin + Colin, P.C., handle brain injury cases. If you have been hurt in an accident due to the negligence of another person, our attorneys may be able to help. Please email us by using the ‘Contact Us’ form on this page.